A Global Affairs Media Network
2016 GLOBAL ACTION REPORT
Shared Value
Abundance
Innovation
CONVENE
CHALLENGE
CONNECT
COMMUNICATE
{ Yes, our world
needs your ideas and leadership.} nashville 2016 November 14 & 15, 2016 Vanderbilt University Nashville, Tennesse USA 2016 Summit Registration: www.globalactionplatform.org Invited guests are top senior level decision makers, leaders and innovators from the corporate, government, academic, media, investment, and NGO communities from around the world.
“The Global Action Platform represents a powerful coalition of cross-sector leaders dedicated to creating abundance through innovation in food, health, and prosperity.”
–
Dr. Fareed Zakaria, CNN
Foreign affairs program “Fareed Zakaria GPS”
and columnist for The Washington Post
The 5th Annual Global Action Summit is a program of the Global Action Platform and the CumberlandCenter, a 501c3 non profit organization Creating abundance through innovation in food, health and prosperity. © 2106 CumberlandCenter, Nashville, Tennessee, USA +1 (877) 300-5806
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GLOBAL ACTION REPORT
CHAIRMAN’S NOTE
THE GLOBALIZATION OF POVERTY: A GLOBALIZED ABUNDANCE RESPONSE
Dr. Scott T. Massey Chairman and CEO Global Action Platform
From Davos, to the Vatican; from China, to Washington, to the capitals of Europe, and across the disruptions of the Middle East, and developing economies, tremendous changes are underway. One of the leading indicators of this grand transition is the growing focus on “income inequality”. The emergence of this issue comes at an inflection point in the early maturity of the globalization-IT revolution that has already changed the world dramatically—and is about to change the world even more dramatically and rapidly. The driving forces of change today are by now easily named, if not yet easily or fully understood. The rapid spread of mobile technologies, combined with the globalization of capital markets and industries, global demographic shifts across generations and cultures, and the 24/7 pervasive knowledge base assembled through the Internet and Big Data—these four converging developments are continuing to undermine traditional political and social orders and to create unprecedented social and economic conditions. The globalization of businesses and economies has also led to a globalization of poverty across developed and developing economies and a vast new gap between centers of wealth and widespread poverty. In addition to these economic and technological forces, today we must also take into account the problem of a globalized refugee population. Across whole regions, the mechanics of government have been used to create private wealth at the expense of the general population of whole nations; and as a result, some sixty-five million people have had to flee their homes due to violence and the collapse of their nation’s economies. The globalization of poverty and the emergence of this vast refugee class both indicate the need for new approaches. The 2016 Global Action Report is intended to provide insight and recommendations for positive strategies to frame the next stage of global development as we navigate the great transitions before us toward greater shared value and abundance. The Report features updates on the Sustainable Development Goals, which hold out the prospect for a transformational agenda for the world. These updates, together with perspective editorials from Fareed Zakaria, Thomas Gass, KPMG, the World Bank, oneC1TY, and the Global Partnership for Sustainable Solutions are combined in our Report with analysis from some sixty international experts and leaders in food, health, and prosperity. To move forward with a reorientation of efforts will require the emergence of a serious abundance agenda. Such an agenda will build on the best research on the creation of shared value prosperity through regional innovation centers anchored in dynamic cluster industries. Regional innovation hubs are the new engines of expanding opportunity and prosperity. Since human creativity is the primary source of sustainable expanding economic growth, a serious abundance agenda will also prioritize human/social needs. Sustainable, scalable abundance requires a flourishing human community within a healthy ecosystem, where innovation and and biological systems both thrive. Economics, environmentalism, and humanism are becoming one. We at Global Action Platform are working to help advance such an abundance agenda and offer this 2016 Global Action Report toward that end. ■
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THE WORLD IN 2050
MASTHEAD
Diplomatic Courier
UN Correspondent
CEO & Publisher
DC Contributors
A Global Affairs Media Network Ana C. Rold
Editorial Advisors Andrew M. Beato Fumbi Chima Sir Ian Forbes Lisa Gable Mary D. Kane Greg Lebedev Anita McBride
Editors
Kathryn H. Floyd Michael Kofman Paul Nash
Writers
Akshan de Alwis
Charles Crawford Justin Goldman Sarah Jones Oscar Montealegre Arun S. Nair Richard Rousseau Mary Utermohlen
GAR Perspectives
Suparno Banerjee Martin Chrisney Ryan Doyle Irene Khan Raymond C. Offenheiser Bryan Thomas Juergen Voegele
Jacob Argue Amar Kakirde Danika Li Winona Roylance
Senior Photographers
Creative Director
Editors@diplomaticourier.org
Christian Gilliham
Director of Social Media Alexcia Chambers
Global Action Platform Steeering Committee Ted Abernathy, Jr. Economic Leadership LLC Justin Bakule Shared Value Initiative Suparno Banerjee Hewlett Packard Cynthia H. Barbera StoryWorld Inc. Jack Bovender HCA (retired) Phil Bredesen Governor of Tennessee (2003-11) John Clifton Gallup Trevor Davies KPMG Marty and Betty Dickens Civic Leaders Ryan Doyle oneC1TY Kitty Moon Emery Global Action Platform Beth Fortune Vanderbilt University Darrell S. Freeman Zycron Computer Services William H. Frist U.S. Senate Maj. Leader (1995-07) Arlene Garrison Oak Ridge Assoc. Universities Jason Gershon GPSS Jonathan Gershon GPSS Adrian Gheorghe EURIS Jose Gonzalez Belmont University Cheryl E. Harrison Global Action Platform
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Michelle Guillermin Sebastian Rich
Letters to the Editors Press/Media
Press@diplomaticourier.org
John Ingram Ingram Industries Clay Jackson BB&R Insurance Mary Kane Sister Cities International Conrad Kiechel Milken Institute Judit Arenas Licea IDLO, United Nations L. Randolph Lowry III Lipscomb University Scott T. Massey Global Action Platform Sultan Julius M.S. Mabandos V Indigenous Peoples Economic Union Connie McGhee Intel Stuart McWhorter Clayton Associates John Morgan TN Board of Regents Ana C. Rold Medauras Global Publishing Jean-Claude Saada Cambridge Holdings, Inc. Howard-Yana Shapiro Mars Incorporated Mike Shmerling XMI Holdings Inc. Thomas J. Sherrard Sherrard & Roe, PLC Sharon P. Shoemaker CIFAR/UC Davis Remy Szykier Aegis Health Security Bryan Thomas GPSS Steve Turner The Family Office Juergen Voegele The World Bank Group Nicholas Zeppos Vanderbilt University
PUBLISHING. The Global Action Report is a product of the Global Action Platform, published in collaboration with Diplomatic Courier, a Global Affairs Media Network. The Diplomatic Courier is produced by Medauras Global, an independent publishing firm based in Washington, DC. The magazine is printed six times a year and publishes a blog and online commentary weekly at www.diplomaticourier.com. EDITORIAL. The articles in this report both in print and online represent the views of their authors and do not reflect those of the editors and the publishers. The authors are responsible for the facts and interpretations. PERMISSIONS. None of the articles can be reproduced without their permission and that of the publishers. For permissions please email the editors at: info@medauras.com with your written request. LEGAL. Copyright Š 2006-2016 Diplomatic Courier and Medauras Global. All rights reserved. No part of this publication can be reproduced without written consent of the publishers. All trademarks that appear in this publication are the property of the respective owners. Any and all companies featured in this publication are contacted by Medauras Global and the Diplomatic Courier to provide advertising and/or services. Every effort has been made to ensure the accuracy of information in this publication, however, Medauras Global and the Diplomatic Courier magazine make no warranties, express or implied in regards to the information, and disclaim all liability for any loss, damages, errors, or omissions. CONTACT. Mailing Address: Diplomatic Courier, 1660 L Street, NW, Suite 501, Washington, DC 20036, U.S. Fax: 202-659-5234. E-mail: info@diplomaticourier.org and editors@diplomaticourier.org. DIGITAL. Digital editions of prior Global Action Reports, Global Action Summit Programs, as well as the 2016 Global Action Report can be downloaded for free on the Diplomatic Courier App on the iStore, Google Play, and Amazon Kindle. ART/PHOTOGRAPHY/ILLUSTRATIONS. In order of appearance: page 3, photo courtesy of Scott T. Massey; page 5, photo by Joyce Boghosian; page 13, UN Photo by Mark Garten; page 15, photo courtesy of Irene Khan and the IDLO; page 17, UN Photo by Cia Pak; page 19, photo courtesy of the Global Action Platform; pages 21-23, all photos courtesy of GPSS; page 24, charts courtesy of KPMG; page 25, UN Photo by Lucien Rajaonina; page 27, UN Photo by Shareef Sarhan; pages 28-31, photos courtesy of oneC1TY; page 34, table chart courtesy of HP and Suparno Banerjee; pages 38-39, photo courtesy of Oxfam America; page 40, infographic courtesy of Oxfam America; page 71, UN Photo by Martine Perret; pages 92-93, all logomarks are property of the respective companies and have been published with permission. All other images and photos by Bigstockphotos.com. WITH APPRECIATION. The Global Action Platform sincerely appreciates the following organizations and university partners. Special Advisors on Food, Health and Prosperity Strategies: The World Bank Institute for Strategy and Competitiveness, Harvard Business School, Vanderbilt Medical Center, and World Food Center, UC Davis. Senior Program Advisors: Aegis Health Security, California Institute for Food and Agricultural Research (CIFAR), Christ Church Cathedral, Global Alliance on Food Security Research, Jack C. Massey College of Business, Belmont University, Oak Ridge Affiliated Universities, Oxfam America, United Nations and the UN Foundation. The Global Action Platform wishes to acknowledge the leadership role played by Aegis Health Security in recruiting impact funds for the new Global Challenge. A digital edition of the 2016 as well as all Global Action Reports and Global Action Summit Programs, is available to download for free on Diplomatic Courier’s App on iStore, Google Play, and Amazon.
PUBLISHER’S NOTE
THE FUTURE IS BETTER THAN YOU THINK Dare to turn on the news. It is a constant bombardment; stories of war, death, terrorism, political scandal, and financial crisis. As consumers we are 10 times more likely to view/click/read negative rather than positive news. Just like a good soap opera, data shows time and again we will follow negative news as far as it takes us. And this is what advertisers like: more eyeballs, more clicks.
Ana C. Rold CEO and Publisher Diplomatic Courier
Ten years ago, I founded Diplomatic Courier, a Global Affairs Media Network, to tell the stories we don’t hear about very often. This is not to say we are oblivious to the major issues humanity is facing, like climate crisis, religious radicalism, and so on. Our focus on finding stories of prosperity and uncommon collaboration was to bring balance to long-form journalism. Our audience has rewarded us handsomely. In just a short and disruptive media decade, Diplomatic Courier has amassed a global readership in over 180 countries and broadcasts content live in multiple platforms, reaching a combined 224 million social media impressions in the last five years. In the Global Action Platform (GAP) we found our kindred spirit. Over the years, we have covered and reported on many of the well-known thought leadership gatherings out there. In GAP we found a community of leaders seeking to effect true change. Since its founding five years ago, we have been the original and enduring rapporteurs. We have designed and produced the report you hold in your hands, capturing the ideas, challenges, and solutions that the GAP community generates each year. We then disseminate to the widest global audience possible: an audience of purpose that shares in the mission for a better world; an audience focused on the positive stories. And despite what major media outlets report, there are many positive stories. Reduction in absolute poverty. Over the last 30 years, the share of the global population living in absolute poverty has declined from 53% to under 17%. While there remains room for improvement (especially in sub-Saharan Africa and South Asia), the quality of life in every region has been steadily improving and will continue to do so. In the next 20 years, we have the ability to extinguish absolute poverty on Earth. Spending less of our income to buy food. According to the USDA, over the last 50 years the percent of our disposable income spent on food has dropped by more than 50 percent - from 14% to less than 6%. This is largely a function of better food production technology, distribution processes, and policies that have reduced the cost of food. Reduced infant mortality rates. In the last 25 years, under-five mortality rates have dropped by 50%. Infant mortality and neonatal mortality rates have also dropped significantly. And this is just in the last 25 years. If you looked at the last 100 years, the improvements have been staggering. A better-educated world. Futurist and fellow optimist Peter Diamandis has said a better-educated world raises all tides. Along those lines, global literacy rates have increased from around 10% to close to 100% in the last 500 years. This is a function of technology democratizing access to education. Many of the solutions for a better future will come from our community at GAP. We hope you will join too. â–
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CONTENTS
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PERSPECTIVES 12 /
A Special Welcome by the UN Secretary General By Ban Ki-moon
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New Global Approaches for Comprehensive Rural Development and Prosperity An Emerging Philippine Case Study By Bryan Thomas
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Leaving No One Behind: A New Development Paradigm
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By Irene Khan
By Martin Chrisney
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The Sustainable Development Goals: A New Way Forward A Conversation with Thomas Gass
Do We Need a Moonshot for the SDGs?
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Models for Urban Innovation: An Update on oneC1TY Nashville By Ryan Doyle
Interview by Fareed Zakaria
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Social Resilience: Information Technology as a Disruptive Enabler By Suparno Banerjee
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Transforming Our Climate-Smart Agriculture Ambitions into Sustained Action By Juergen Voegele
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Ending Global Hunger Through Private Sector, Civil Society and Government Collaboration By Raymond C. Offenheiser UN Photo / Cia Pak
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FOOD SESSION 1
SESSION 4
Beyond Aid: A New Paradigm for Global Development
Achieving Sustainable Agriculture
Session Panelists: Diana L. Olhbaum, Senior Associate, Center for Strategic and International Studies (CSIS) Cain Prince Andrews, Director General of Monrovia, Liberia Daniel Osusky, Standards Development Manager, B Lab Moderator: Paul O’Brien,Vice President for Policy and Campaigns, Oxfam America
Session Panelists: Minos Athanassiadis, Senior Director, Agrian Inc. Daniel L. Schellenberg, Post-Doctoral Student, UC Davis Steve Shaffer, Environmental Consultant, American Farmland Trust Sharon Shoemaker, Director, California Institute of Food & Agricultural Research Moderator: Daniel van der Lelie, Global Director, Biosolutions, R&D, FMC Corporation
SESSION 2
SESSION 5
Ending Hunger, Achieving Food Security and Improved Nutrition: Milestones and Dimensions On a Path for Feeding the World
The Garden and The Banquet: Cultural Meaning of Farming and Food
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Session Panelists: Roger Beachy, Director,World Food Center, UC Davis A.G. Kawamura, Former California Secretary of Agriculture, Farmer Iftikhar Mostafa, Senior Agriculture Economist, The World Bank Group Prabhu Pingali, Director, Tata-Cornell Agriculture & Nutrition Initiative Moderator: Lawrence Haddad, Co-Chair, Global Nutrition Report
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Session Panelists: A.G. Kawamura, Former California Secretary of Agriculture, Farmer Jeff Pfitzer, Program of cer, Benwood Foundation Bishop William Swing, President and Founding Trustee, United Religions Initiative Moderator: Woody Tasch, Founder and Chairman, Slow Money Institute
SESSION 3
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Strategies for Improved Food Security, Food Safety, and Waste Mitigation Session Panelists: J. Bruce German, Director, Foods for Health Institute, UC Davis Pingfan Rao, Vice President, Chinese Institute of Food Science & Technology, Director, Food Project (China), Future Earth TC Wang, Director, R&D, Anyou, Animal Nutrition Specialist Ltd. Weston Warren, Chief Science Of cer, Puradigm, CEO, Nanovo Moderator: Hans Herren, President, Millennium Institute
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CONTENTS
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HEALTH SESSION 1
SESSION 3
The Healthy Environment: Environment, Infection and Health
Strategies to Achieve Health: Advanced, Developing and Underdeveloped Regional Strategies
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Session Panelists: Ryan Doyle, General Manager, oneC1TY Nashville Michael Graziano, Founder, small-r Lee Lorenzen, Staff Researcher, Department of Pharmacology, UC Irvine Weston Warren, Chief Science Of cer, Puradigm and CEO, Nanovo Mary Ann Wamerdam, External Regulatory Affairs Leader, Global Stewardship and Innovation, The Clorox Company Moderator: Dennis Grimaud, CEO, Diatherix
SESSION 2
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Frontiers of Health Data Analytics Session Panelists: Kelly Aldrich, Chief Clinical Transformation Officer, Center for Medical Interoperability Mary Mirabelli, Vice President, Global Healthcare Services, HP Enterprise Services, LLC Remy Szykier, Managing Partner, Aegis Health Security Moderator: Niall Brennan, Director and CMS Chief Data Officer, Centers for Medicare and Medicaid Services
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Session Panelists: Nick Assad, Senior Vice President, Business Development, CirrusMD Joxel Garcia, Executive Director, Cancer Prevention and Control Platform, University of Texas MD Anderson Cancer Center Alex Philp, Founder and CEO, Upstream Health Herman Williams, SVP and Chief Medical Officer, RegionalCare Hospital Partners Moderator: Robert Dittus, Associate Vice Chancellor for Public Health, Vanderbilt University Medical Center SESSION 4
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Value Health: Delivering Value in Perinatal Care Session Panelists: Peter Grubb, Medical Director, Tennessee Initiative for Perinatal Quality Care, Associate Professor of Pediatrics,Vanderbilt University Medical Center Kelly McQueen, Director, Global Anesthesia Program, Fellow, Harvard Humanitarian Initiative Bill Paul, Director, Metropolitan Nashville Health Department Moderator: Remy Szykier, Managing Partner, Aegis Health Security
SECTION
PROSPERITY SESSION 1
SESSION 4
Ending Poverty in All Forms Everywhere: Regional Economic Solutions (SDG1)
The Future of Impact Investing
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Session Panelists: Matt Erskine, Deputy Assistant Secretary of Commerce for Economic Development & COO, U.S. Department of Commerce Jan Rivkin, Bruce V. Rauner Professor of Business Administration, Harvard Business School, U.S. Competitiveness Project Loren Rodgers, Executive Director, National Center for Employee Ownership Bishop William Swing, President and Founding Trustee, United Religions Initiative (URI) Moderator: Mukhisa Kituyi, Secretary-General, United Nations Conference on Trade and Development (UNCTAD)
SESSION 2
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Shared Value and Global Economic Inequality Session Panelists: Tom Bakkum, Innovation Lead, Climate-KIC, European Union Danielle Corley, Researcher, Center for American Progress Shira Kilcoyne, Director of Government Affairs, GSK Todd Lemons, Founder, InfniteEarth Moderator: Justin Bakule, Executive Director, Shared Value Institute
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Session Panelists: Craig Heryford, Shareholder, Buchanan Ingersoll and Rooney Jim Schorr, CEO, Social Enterprise Alliance Michael Shmerling, Chairman, XMi Holdings, Inc. Woody Tasch, Founder, Slow Money Moderator: Remy Szykier, Managing Partner, Aegis Health Security
SESSION 5
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Finding, Tracking and Scaling Solutions to Achieve the SDGs Session Panelists: Puneet Ahira, Systems Architect and Special Advisor to the U.S. Chief Technology Officer, The White House Kevin Harmon, Founder and CEO, Brisa International Pat Walsh, Co-Founder, Chief Impact Of cer, Classy Moderator: Jay Corless, Senior Director for Innovation, UN Foundation
SESSION 3
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Training Leaders for Shared Prosperity: Developing Future Regional Economic Leaders Session Panelists: Penny Judd, President, PennAvenue Strategies Shaka Mitchell, Regional Director (TN), Rocketship Education Melissa Waddey, Senior Vice President, Operations Strategy and Integration, Lifepoint Health Marcus Whitney, President, Jumpstart Foundry Moderator: Manjari Raman, Program Director and Senior Researcher, U.S. Competitiveness Project, Harvard Business School
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PERSPECTIVES
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WELCOME / UNITED NATIONS
A Special Welcome by UN Secretary General Ban Ki-moon
I
n his brief welcoming address to the 2015 Global Action Summit, UN Secretary-General Ban Kimoon attributed the remarkable progress that has been made towards the Millennium Development Goals to one thing: solidarity. Building upon that success, the UN and collaborating partners conducted two years of formal discussions with key stakeholders in the private sector, governments, NGOs, and intergovernmental agencies to create a new agenda. With 193 UN member countries and a global population over 7 billion, the task of creating a global cross sector consensus was daunting. However, the impact of the Millennium Development Goals and the collaborations created around the MDGs provided a strong impulse to continue. The post-2015 successor of the MDGs, the Sustainable Development Goals were adopted in September 2015 and are even more ambitious. With 17 goals and 169 targets the SDGs, as they are commonly known, will attempt to eradicate poverty, combat climate change, and fight inequality
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and injustice. “That vision,” Ki-moon remarked, “emerged from the most inclusive global consultation process in the history of the UN” Governments, activists, and millions of concerned citizens around the world came together to promote their shared vision of humanity. “Now we need all of these partners to remain united and to rally behind the goals and turn them into tangible improvements in the lives of people everywhere,” continued Ki-moon. Success for the SDGs are likely to require increased engagement of the private sector in shared value business strategies and increased innovation and international cooperation. The SDGs, by design, take a difficult approach, focusing not just on average outcomes, but also on individuals. Since the economic downturn in 2008, developed economies have faced low to flat growth rates, and developing countries, because of their dependence on natural resources and the recent fall in commodity prices, have been unable to post substantial growth. However, this does not mean that humanity cannot advance toward the SDG’s vision. On the contrary, relatively
low growth may be beneficial, refocusing the world’s attention on those who have been left behind, and on issues that, like sustainability, have been neglected as we advanced. As we begin to approach the limits of the current economic order, several responses are possible. One option is that corporations and nation-states, seeking to preserve the status quo situation, may become more hostile as they fight over diminishing returns, leading to greater inequality and human strife. Alternatively, corporations, governments, NGOs, and global citizens may join together to pursue new shared value strategies and solutions to ensure peace and prosperity for all. The Sustainable Development Goals present a framework for cooperation and global solutions for all people. By signing the Sustainable Development Goals, the member states of the United Nations have agreed to work towards these aims. Solidarity has perhaps never been more needed. ■
UNITED NATIONS
UN Photo / Mark Garten
Ladies and gentleman, welcome to the 2015 Global Action Summit. I thank Fareed Zakaria, the moderator, and Chairman Scott Massey for the chance to join you. The Sustainable Development Goals can realize our vision to end poverty and create peaceful societies on a healthy planet. That vision emerged from the most inclusive global consultation process the history of the United Nations, involving governments, activists, businesses, and millions of concerned citizens across the world. Now, we need all of these partners to remain united, and to rally behind the cause as we embark on the crucial work of translating them into tangible improvements in the lives of people everywhere. I thank the participants in this summit for working on sustainable solutions for food, health, and prosperity. You have achieved great progress so far through the Global Action Forum. Now is the moment to become even more engaged. I have been asked to name the key reason that countries made such remarkable progress towards the Millennium Development Goals. The answer is solidarity. Solidarity means national action matched by international support. When we activate a strong spirit of solidarity, we secure our common future. Thank you. SEPTEMBER 2016
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LEAD PERSPECTIVE / IDLO
Leaving No One Behind: A New Development Paradigm BY IRENE KHAN
I
n a world torn by armed conflict, scarred by extreme poverty and inequality, threatened by climate change, and at the same time, experiencing enormous breakthroughs in science, technology and economic growth that could make this a much better place for all, people’s demand for change is deafening. In September 2015, the world’s leaders took a historic step at the United Nations adopting the 2030 Agenda for Sustainable Development: a global agenda of unprecedented scope and significance. “We are resolved to free the human race from the tyranny of poverty and want and to heal and secure our planet”, governments said and committed themselves to a transformative “plan of action for people, planet and prosperity”. Transformational change requires that we look at sustainable development with a new lens: sustainable development is at its core a call to address the injustices created by extreme poverty, growing inequalities, over consumption and environmental degradation. No injustice can be set right without the rule of law. In a ground-breaking move, the 2030 Agenda has put justice and the rule of
law firmly at the heart of development. It is no longer an optional extra, but a premise without which development cannot be sustained. Goal 16 acknowledges that access to justice, the rule of law and effective, inclusive institutions are essential ingredients of sustainable development. Clean government is as important as clean water. But the relationship between the rule of law and the 2030 Agenda goes deeper than Goal 16. The rule of law is about equal protection, accountability and transparency. In that sense, it cuts across all the Sustainable Development Goals. Without access to justice and the rule of law, development cannot flourish, investment will not take root, the planet cannot survive, the poor cannot overcome poverty, women cannot fight discrimination and become agents of their own destiny. No matter where in the development spectrum a particular country stands, establishing peace or protecting the planet, eradicating poverty or encouraging economic opportunity, requires good laws and regulations that are fairly administered by transparent
“Protecting the planet, eradicating poverty and hunger, fighting inequality, guaranteeing health, creating more inclusive societies, promoting economic opportunity, all require good laws and regulations that are fairly administered by transparent and accountable institutions and that produce fair outcomes for all.”
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and accountable institutions and that, most importantly, produce fair outcomes for all. As the world grapples with an unprecedented number of humanitarian crises, we must recognize that a strong, independent judiciary and properly trained police, prosecutors and border officials, backed by laws and regulations in line with international obligations, mean that in times of crises there are well-established institutions to uphold international law and humanitarian norms and address impunity. Developing the capacity of legal and justice systems is critical for effective humanitarian response. However, changes in development fortunes occur only when the poor and marginalized are empowered to act and address the root causes of their impoverishment and disempowerment. People must be made aware of their rights so that they are able to claim them. IDLO’s field experience and research and that of others suggest that the poor are empowered through access to justice and information, just laws and capable institutions. The rule of law is about equal
IDLO
protection of rights, about leaving no one behind. By empowering people it helps to build resilient societies. By strengthening the integrity and capacity of institutions, it ensures justice and accountability. Protecting the planet, eradicating poverty and hunger, fighting inequality, guaranteeing health, creating more inclusive societies, promoting economic opportunity, all require good laws and regulations that are fairly administered by transparent and accountable institutions and that produce fair outcomes for all.
Delivering on 17 SDGs is ambitious and will require commitment to the Global Partnership that needs all members of society to work together to implement it: civil society, governments, the private sector, academia and multilateral organizations. Agenda 2030 is an inspiring document – but it will become a truly transformative agenda only when the words are converted into action. â–
Irene Khan is Director-General of the International Development Law Organization (IDLO). The first woman to hold this office, she was elected by Member Parties on 17 November 2011 and took up her position formally on 1 January 2012 for a term of four years. An international thought leader on human rights, gender and social justice issues, Irene Khan was Secretary General of Amnesty International from 2001 - 2009. Ms. Khan is a member of the World Bank Advisory Council on Gender and Development. She sits on the boards of several international human rights and development organizations. Ms. Khan received the Sydney Peace Prize in 2006 for her work to end violence against women and girls. Her book, The Unheard Truth: Poverty and Human Rights, has been translated into seven languages. Born in Bangladesh, Irene Khan studied law at the University of Manchester and Harvard Law School.
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The Sustainable Development Goals: A New Way Forward A Conversation with Thomas Gass and Fareed Zakaria
A
s the feature presentation of the Global Action Summit, Washington Post columnist and host of CNN’s flagship foreign affair show, Fareed Zakaria interviewed Thomas Gass. Gass is head of the Department of Economic and Social Affairs at the UN, having been appointed by Secretary-General Ban KiMoon in 2013. Their conversation aimed to clarify the Sustainable Development Goals (SDGs), which came out this September in New York. Zakaria began by lauding Gass for his fieldwork in Nepal. “Development is not just an abstraction he is working on at the UN,” Zakaria praised, “but something he has really lived and breathed for years and years.” Gass maintained this image throughout the discussion by referring to pitiable examples of people falling through the cracks of the bureaucracy. “Sometimes,” Fareed began, following Gass’s lead, “inequality is not generated by a lack of skills, or not working hard enough… they are almost built into the economy.” “That’s why I’m so passionate about this agenda,” Gass replied. Simple things like geography can be substantial barriers to progress, especially in a place like Nepal, where “the next village may be only a few hundred meters away in a straight line, but there is a raging river in between and a valley 1500 meters deep.” The solution, “We built trail bridges.”
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Gass continued, “It’s amazing how it can bring a health post nearer, a school nearer, or a district office where you could register to vote...Infrastructure is linked to civil empowerment,” he concluded. Gass radiated a sense of joyous optimism— and with good reason: the Millennium Development Goals, which culminated in 2015, have largely been met. Zakaria was more restrained in his assessment, pointing out that rapid growth markets like China and India have contributed most of the progress, and that in other regions, especially Sub-Saharan Africa, satisfactory change has been lagging. “I wonder if,” Zakaria theorized, “[thus far] you have gotten the lowhanging fruit, and you are now getting to the bottom billion,” alluding to Oxford economist Paul Collier’s book of the same name. “These people live in extreme poverty because they live in extremely dysfunctional, corrupt regimes. How are you going to pull this off?” Zakaria questioned. “That bottom billion counts,” Gass said matter of factly. “We will need to approach this new challenge in new ways…economic growth is still important, but many more actions, many more activities will have to be engaged in to reach that bottom billion.” This attitude is reflected in the Sustainable Development Goals, which are far more radical than their predecessor. With 17 goals and 169 targets, the SDGs are also ➥
GLOBAL ACTION PLATFORM
UN Photo / Cia Pak
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considerably more diverse than the eight goals and 18 targets of the MDGs. “When you have so many targets, so many goals,” Zakaria wondered, “aren’t you just going dissipate the focus…from the four or five that should be the key metrics that you should look at?” “The Millennium Development Goals were much more focused; they were a strategic plan to address the most important issues in developing countries,” Gass replied. Referring to the Sustainable Development Goals, he continued: “The shared vision of humanity is more complex. It is not a strategic plan.” “If you really want this new agenda for sustainable development to move forward you have to make this shared venture of humanity into a new social contract between the leaders and the people,” Gass observed. The accountability is shifting. Whereas with the MDGs and previous aid measures the relationship had been between “donors and recipients, developed countries and developing countries, the North and the South, here there is a very clear emphasis that the accountability, the implementation, the leadership, the ownership, has to be with the national level,” Gass remarked. The change is a welcome one for some, who see it as a way to simplify the process and direct energy where locals know it is needed, rather than where the bureaucrats insist, but others question the new strategy’s ability to tackle these problems for people struggling in countries dominated by corrupt regimes. Since these are still goals, and not yet policies, only time will tell whether the new MO will be more or less effective. “The SDGs are not just a miracle solution that can be applied in a cookiecutter approach across developing countries,” Gass clarified. “This is an agenda that addresses the complexity of the human challenges, the complexity of the interaction between the natural resources, between the planet, between the economics, between the social issues.” Many issues, left untouched in the Millennium Development Goals have been brought to the fore in the Sustainable Development Goals. There is a “much stronger emphasis on climate change,” but “the big, revolutionary paragraphs… are that inequalities lead
➥
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“That bottom billion counts,” Gass said matter of factly. “We will need to approach this new challenge in new ways…economic growth is still important, but many more actions, many more activities will have to be engaged in to reach that bottom billion.” This attitude is reflected in the Sustainable Development Goals, which are far more radical than their predecessor. With 17 goals and 169 targets, the SDGs are also considerably more diverse than the eight goals and 18 targets of the MDGs.
to injustice” Gass said. “Going forward we are not going to be able to hide behind averages anymore… It is going to be about that bottom billion, wherever it is distributed.” Connecting all these issues into a coherent framework in which many issues are intertwined through positive feedback loops is a step in the right direction. The destitute African mother does not think about she has no clean water, no education, no medical treatment, no way to feed her children, etc.: she simply has nothing. While these issues may require the expertise of distinct professionals, it can be helpful to consider that it is the same person being acted on. Health and nutrition took on renewed significance in the SDGs, being goals number two and three, respectively. Gass connected it to the resource challenge: “We like to be in denial about the natural resources we have. The value chain has to be sustainable.” Fitting for a document that is meant to be the shared vision of humanity, it affects not only developing countries, but also developed ones. Everyone has a part to play, and the Global Action Summit was a signpost of its attendees’ commitment to positively changing the world. ■
GLOBAL ACTION PLATFORM
SEPTEMBER 2016
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PERSPECTIVE / GPSS
New Global Approaches for Comprehensive Rural Development and Prosperity An Emerging Philippine Case Study BY BRYAN THOMAS
T
hroughout human history, the contact between developed economies and indigenous people in undeveloped areas has created tension, and often tragedy. Today the challenge of creating a positive connection between developing and advanced orders remains a pressing, if elusive goal. On the one hand, advanced technologies and markets offer benefits needed by indigenous people in today’s world. On the other hand, connecting indigenous peoples with global markets and technology can be extremely disruptive, often resulting in vastly unequal benefits to the two sides. So the compelling question remains: how can the transformational power of advanced technologies and markets be connected in constructive ways with indigenous societies in undeveloped, endowment–rich regions? The challenge can be illustrated today in the Philippines. With ninety-seven percent of the primary forest cut for timber, ninety percent of the coral reefs endangered, cities filled with high levels of pollution, and the majority of the indigenous peoples, lacking even birth certificates, surviving without education, healthcare, sufficient food supply, and hope for a productive and prosperous future, the problems are clear. But now, new developments in the Philippine government and with new global partnerships emerging, the Philippines can also, perhaps, offer the world a model for how to manage a shared value integration of indigenous and advanced societies.
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IPRA Law The story begins in 1997, when President Fidel V. Ramos signed historical legislation creating the Indigenous People’s Right’s Act of the Philippines. This Act empowers the indigenous peoples of the Philippines to govern themselves and to claim ownership and development rights for their ancestral domains and natural resources. As a result of this legislation, 5.1M hectares of land on the island of Mindanao now belongs to the 40 indigenous people groups who inhabit the region. The new President of the Philippines, Rodrigo Duterte, is committed to the continuation of this legislative agenda, and has appointed new executive leadership throughout government agencies who are dedicated to integrity, the elimination of poverty, and the empowerment of indigenous peoples. In response to this unprecedented opportunity, various indigenous people groups in the Caraga Region have joined together to create the Indigenous People’s Economic Union (IPEU).
By joining together, IPEU and other groups are also creating new opportunities for comprehensive rural development in partnership with a new generation of global initiatives grounded in shared value. A New Global Approach: Global Partnership for Sustainable Solutions and Global Action Platform In 2015, the IPEU and other tribal groups requested that the Global Partnership for Sustainable Solutions (GPSS), including the Global Action Platform as the exclusive nonprofit representative, be their official international development partner. The Global Partnership for Sustainable Solutions brings responsible companies, institutions, and investors together into emerging markets for sustainable development and is dedicated to creating community models for sustainable solutions and development issues in disadvantaged regions of the world, starting with the Philippines. Global Action Platform ➥
“The Global Partnership for Sustainable Solutions brings responsible companies, institutions, and investors together into emerging markets for sustainable development and is dedicated to creating community models for sustainable solutions and development issues in disadvantaged regions of the world, starting with the Philippines.”
PERSPECTIVE / GPSS
SEPTEMBER 2016
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PERSPECTIVE / GPSS
“In 2015, the IPEU and other tribal groups requested that the Global Partnership for Sustainable Solutions (GPSS), including the Global Action Platform as the exclusive nonprofit representative, be their official international development partner.”
➥ is the world’s leading universitybusiness alliance advancing scalable, sustainable solutions for abundant food, health, and prosperity. Together, GPSS and Global Action Platform are dedicated to a comprehensive social, economic, and environmental approach that creates shared benefit and global impact. The IPEU – GPSS/GAP partnership is creating a model for scalable, sustainable, shared value solutions of integrated economic, educational, social, and environmental development that can be replicated in other parts of the world. During the past year, this emerging new partnership has created plans and connected leading companies for development in agriculture, forestry, responsible mining, and aquaculture. Our initiative is now entertaining requests for information and collaboration from foundations, investors, and companies who are interested in partnering and creating joint ventures to develop the 500,000 hectares of land currently assigned for immediate development. We are dedicated to empowering the indigenous peoples of Caraga to change history and create not only a prosperous future for the Philippines, but also a model that can be replicated in other developing regions, especially on the continents of Asia, Africa, and Latin America. 22
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The Caraga Comprehensive Development Plan being created by GPSS/GAP – IPEU addresses targets within all seventeen Sustainable Development Goals (SDG’s) released in 2015 by the United Nations. International foundations, agencies, impact investors, university leaders, philanthropists, and socially and environmentally responsible companies interested in obtaining more information may contact GPSS via bryan.thomas@gpssglobal.com, jonathan@gpssglobal.com, or stmassey@globalactionplatform.org. ■
Bryan Thomas is a multilingual, multicultural CEO and Managing Partner of Global Partnership For Sustainable Solutions. He’s led successful start-up organizations in four countries, and provided effective organization development consulting on four continents. Bryan has spent three decades developing indigenous leaders and projects throughout the Philippines and former Soviet Union. He has BS degrees in Linguistics, Cultural Anthropology and Education, and MA in Sociology focused on Leadership & Organization Development. Bryan is also a writer and has taught and challenged over a million people in 25 countries through his public speaking.
PERSPECTIVE / GPSS
SEPTEMBER 2016
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PERSPECTIVE / KPMG
Do We Need a Moonshot for the SDGs? BY MARTIN CHRISNEY
O
ne year has passed since world leaders adopted the Sustainable Development Goals (SDGs), a pledge to eliminate poverty, hunger, and 15 other global goals by 2030. In the latter half of the 20th century, a similarly ambitious vision galvanized our ingenuity, finance, and scientific community to the common endeavor of putting a man on the moon. Today, do we need a similar moon-shot approach for the SDGs?
Progress so far
Are we there yet?
Since the original moonshot announcement by John F. Kennedy in 1961, the developing world has witnessed enormous social and economic progress. Democracies have taken hold across the globe, poverty levels declined dramatically, and the global economy has become more interconnected. In terms of living standards, real incomes in developing economies have risen three-fold and poverty has fallen below 10 percent—besting the target set in the Millennium Development Goals (the predecessor to the SDGs). Advances have been made in health and education with both improved coverage and greater quality. These gains in well-being and the accompanying technological revolution of recent years led the late Michael Elliot, head of the One Campaign, to refer to this as an “age of miracles.”
Still, there is still some distance to cover. The costs of climate change, persistent poverty affecting some 900 million people , the challenges of fragile and conflict-affected states, along with large infrastructure deficits indicate that we have some way to go. The price tag to address these global challenges is steep. In developing countries some $2.5 trillion a year in additional spending is needed, many times the estimated $200 billion spent to put man on the moon. While the unmet needs are sizeable, the amount of official development assistance (ODA) has been largely stagnant since the 1960s. Private investment flows have now eclipsed ODA as a dominant source of funds for developing economies. ➥
Trends in Developing Economies and World
(a) Developing economies are the 31 low income countries in the World Bank’s classification. (b) Data are for the 129 IDA and IBRD borrowing member countries. Source: World Development Indicators, 2016
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Foreign Direct Investment and Official Flows to Developing Economies
Source: World Development Indicators FDI is net flow toWorld Bank Group borrowing member countries; Official flows are global net flows.
PERSPECTIVE / KPMG
UN Photo / Lucien Rajaonina
SEPTEMBER 2016
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PERSPECTIVE / KPMG
“Innovations in the use of SMS texting mean that a pregnant woman in rural Peru receives messages from her doctor and reminders for her medical appointments – improving her baby’s health and reducing time spent in waiting rooms. In Thailand, villagers collaborate to design ‘bottom up’ strategies to improve educational access for girls and boys. When these efforts are replicated, and when possible scaled up, these will be the small steps that move humankind ever closer to its common goal of improving lives and reaching the SDGs.”
➥ Keys to success
Achieving the SDGs is more than a financial and technological feat. Realizing sustainable and equitable change will challenge our ability to organize and collaborate across sectors and with multiple actors – North-South, SouthSouth, and Public-Private-Civil Society. Given their breadth and scale, there are some basic organizing principles that should guide these efforts to make the SDGs a reality. Embrace transparency Eliminating poverty and hunger are complex challenges that defy simple solutions. In order to speed the identification and replication of successful efforts transparent and open access to data should be the default, not the exception. This is especially true regarding data on development projects and programs where governments and donor funds often finance overlapping activities, fail to exploit synergies, or do not learn from their predecessor’s efforts. All this leads to inefficiency and waste, and, at worst, can distort incentives. Focus on results The SDGs are a yardstick to measure success. These outcomes should guide the actions of governments, donors, and investors alike. For that to happen, ODA and investment should use monitoring and evaluation criteria that inform policymakers and investors by providing clear, measureable indicators of success. Published results and evaluations should be used to justify continuing to investment in successful programs, ending ineffective ones, and scaling up pilot programs that are proven. Foster collaboration Achieving the SDGs requires the collaboration of public, private and
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civil society actors. A first step will be building the partnerships needed to tap into the trillions of dollars of latent investment and donor resources among pension fund managers, impact investors, remittance flows, private investment, and philanthropy. These partnerships should be based on co-creation, shared risks and responsibilities, and interdependency so each player has “skin the game.” An organizational transformation is also needed among traditional development institutions to leverage their resources and results using new approaches to deliver goods and services. Successful models to follow include the Advanced Market Commitment and the Global Alliance for Vaccines and Immunizations (GAVI) – which spurred the development and distribution of life-saving medicines in developing economies. More businesses will also need to adopt “shared value” approaches that offer positive social and environmental outcomes while contributing to the bottom line. To encourage and recognize leaders in this field, KPMG is proud to sponsor the Share Value award at the 2016 Global Action Platform. Encourage innovation An innovation ecosystem that invests in experimentation and learning is critical. Examples include the use of challenge funds, like the African Enterprise Challenge Fund (AECF) that pilots, tests, and scales new approaches to address poverty, and create sustainable employment. Innovations in the financing of development are also essential. More than ever, equity and other forms of risk capital are needed. To become risk-takers donors will need to adopt a mindset that recognizes that failure is an expected as part of the process, offering an opportunity to learn and improve the return on future investments.
An Age of Miracles The good news is that across the world, these principles are already being adopted, and are bearing fruit. Efforts like the International Aid Transparency Initiative (IATI) to open up data from development agencies and the Open Data Charter that encourages greater data sharing by governments can promote increased interaction with business, citizens, and civil society. Today, public funds and impact investors are financing schools in rural Kenya where children learn from teachers whose curriculum is transmitted by smart phone and tablet at a cost of just pennies a day. Innovations in the use of SMS texting mean that a pregnant woman in rural Peru receives messages from her doctor and reminders for her medical appointments – improving her baby’s health and reducing time spent in waiting rooms. In Thailand, villagers collaborate to design “bottom up” strategies to improve educational access for girls and boys. When these efforts are replicated, and when possible scaled up, these will be the small steps that move humankind ever closer to its common goal of improving lives and reaching the SDGs. ■
Martin Chrisney is the Director of KPMG’s International Development Assistance Services Institute where he coordinates the delivery of strategic and technical work on development topics. Martin has worked extensively with governments, multilateral development banks, bilateral agencies, non-profit organizations, and the private sector during his time with the IADB and the World Bank.
PERSPECTIVE / KPMG
UN Photo / Shareef Sarhan SEPTEMBER 2016
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PERSPECTIVE / ONEC1TY
Models for Urban Innovation: An Update on oneC1TY Nashville BY RYAN DOYLE
S
ince our groundbreaking at 31st and Charlotte Avenue roughly two and a half years ago, people of all backgrounds and interests, have asked me “What is oneC1TY?” I’ve learned from the questions… answered those that I could and most importantly, I’ve absorbed the perspective of the people asking them. oneC1TY started as an idea influenced by the healthcare industry experiences throughout my career, my company Cambridge’s commitment to building communities more sustainably and mindfully, and an investment by our City to literally connect Nashville’s West Side like never before, with a bridge that is shared between pedestrians, bikes, automobiles and trees. Our goal was to define Global Thought, Local Impact and Personal Health in a way that only Nashville is capable. Through our partnership with the Global Action Platform, we are in the front row as our City participates in the Rockefeller Foundation’s 100 Resilient Cities program, where work will be done to examine and implement strategies for sustainable economic, environmental and infrastructure growth throughout Middle Tennessee.
Locally, oneC1TY is integral to the work of Urban Land Institute’s Healthy Corridor strategies. Initiatives like this one and the Nashville Civic Design Center’s Shaping Healthy Communities will make an impact on the design and development of the dense, multi-modally connected corridors recommended through the Nashville Next process and plan. And within these global and local examples, our 19 acres are planned to become the “public square” to a much broader and more diverse surrounding community, hosting the opportunity for technology to continue our healthcare industry’s evolution. While the business community positively disrupts their industry, oneC1TY will be a world-class case study for how the built environment positively impacts health. We believe we will make a lasting impact on personal well-being through the foundational ground floor experience that promotes connectedness with nature, walkability, fresh food, life-long learning and social gathering opportunities. Place-making qualities that we believe consumers measure, subconsciously or consciously, when exploring how and where to live life. The initial step in implementing our vision is now complete. We’ve developed previously underutilized land in ➥
“We’ve developed previously underutilized land in our City’s medical and university district into a connected, completely integrated site with sustainable water strategies, a network of complete streets, agnostic ber optic capabilities and more than four acres of open space, all without relying on City funds.” 28
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ONEC1TY
SEPTEMBER 2016
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PERSPECTIVE / ONEC1TY
“Through our partnership with the Global Action Platform, we are in the front row as our City participates in the Rockefeller Foundation’s 100 Resilient Cities program, where work will be done to examine and implement strategies for sustainable economic, environmental and infrastructure growththroughout Middle Tennessee.”
➥ our City’s medical and university
district into a connected, completely integrated site with sustainable water strategies, a network of complete streets, agnostic fiber optic capabilities and more than four acres of open space, all without relying on City funds. We’ve opened and fully leased our first commercial building to a diverse group of innovative organizations ranging from locally founded MediCopy, to multi-national Microsoft, to patient-centric Tennessee Orthopaedic Alliance, to the health technology coalition of the Center for Medical Interoperability. And to begin our food centric strategy we’ve partnered with James Beard award winner Gerard Craft on his restaurant Pastaria, and nationally acclaimed Scott Carey, who will bring the art of roasting and experiencing coffee to Sump Coffee. To kick-off step two, we’ve begun construction on our first residential community within oneC1TY, providing space for more than 350 Nashvillians to find sustainable living, proximate to where they develop their intellect through work and study. We will soon break ground on our eco-conscious and active lifestyle focused hotel, which will offer travelers the chance to continue their healthy habits while joining our innovative business ecosystem or immersing themselves in local arts and culture in our neighborhood and throughout the City. Finally in this phase, we will begin two more commercial office buildings, totaling more than 200,000 square feet and focused on housing technology and creative companies in workspaces that foster “a new way of thinking.” At the completion of these live, work and visit spaces, we will also have added approximately 50,000 square feet of inventive, locally sourced food and high-energy fitness.
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In future phases, we will add three more buildings, including additional residential and office space, bringing our community program to 1 million square feet of office space, 600 dwellings, 170 hotel rooms and more than 100,000 square feet of ground floor retail. Over the duration of our development, we expect to see continued growth surrounding us on the West Side, connecting Midtown to North Nashville and the Central Business District to West Nashville’s historic neighborhoods. oneC1TY is not intended to be a neighborhood kept to itself, but rather a catalyst to lead the West Side towards principles that build a stronger community … economically, equitably, creatively, nutritiously. So the answer to “What is oneC1TY?” isn’t always straightforward. oneC1TY has several interconnected parts, just like any strong neighborhood should. The answer is often different to different people, but after living with that original idea and beginning to implement our global, local and personal goals; it is ever more evident to me that oneC1TY is first about the people that make it. Their ideas, their ability to collaborate and connect, their enjoyment in the spaces they share, their daily journeys and accomplishments. I appreciate the individuals who currently make up the “we” in “we are oneC1TY” and look forward to those that join us and seek to learn from our themes in neighborhoods around the globe in the years to come. ■
Ryan Doyle is Vice President of Cambridge Holdings, Inc., and General Manager of oneC1TY Nashville.
ONEC1TY
8 C1TY Boulevard, the first building at oneC1TY.
SEPTEMBER 2016
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PERSPECTIVE / HEWLETT PACKARD
Social Resilience: Information Technology as a Disruptive Enabler BY SUPARNO BANERJEE
W
e are seeing a fundamental shift in the transformation of cities. There is a conscious move away from implementing point solutions that address the most visible pain points to a much broader approach that adopts a solutions portfolio to deliver fundamental outcomes for citizens, communities and businesses. In a world that is being buffeted by turbulence and uncertainty, enhancing city resilience has become a major area of focus. Rockefeller Foundation’s 100 Resilient Cities defines resilience as “the capacity of cities to function, so that the people living and working in cities – particularly the poor and the vulnerable – survive and thrive no matter what stresses or shocks they encounter.” Benson defines social resilience as “the ability to withstand, recover from, and reorganize in response to crises so that all members of society may develop or maintain the ability to thrive”. It is interesting to note the common thread running through these two definitions of resilience is a focus on people, especially the poor, elderly and the vulnerable. A closer look reveals that crises are not even-handed as far as the impact on people is concerned. In Hurricane Katrina, more than 70% of the people who perished were aged above 60. Close to 50% of the fatalities from Superstorm Sandy were people 65 or older. In The Great East Japan Earthquake of 2011, more than 32
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two-thirds of those who lost their lives were over 60 years old. Other vulnerable segments experience impacts that are disproportionate in scale. The Institute for Women’s Policy Research (IWPR), in a 2010 policy document, noted that since poorer women have less “mobility and access to resources”, they are more vulnerable in natural disasters. Data shows that sexual assault rates in Mississippi rose from 4.6 to 16.3 per 100,000 per day, a year after Hurricane Katrina, partly because many women were forced to leave their homes and live in shelters. In the spate of floods in cities in Asia, the poor (and the elderly poor) have suffered the most. The impact on the elderly, the poor, the disadvantaged has been devastating. There are multiple reasons for this disparity in impact, including: ■ Illness and restricted mobility. ■ Physical and social isolation – the elderly often live alone. ■ Location – the elderly or the poor often live in the most vulnerable areas as property prices in these locations are the cheapest. ■ Disabilities and health conditions: In Japan during the earthquake, those with dementia were too disoriented to evacuate. Often, those impacted are left in conditions with insufficient food, water, exposed to heat or cold, and sometimes without life-saving drugs – conditions that place vulnerable segments, the elderly and the young, at grave risk.
HEWLETT PACKARD
“Data from a Pew Research study indicates that almost half of the 60 million Americans who do not have access to the internet are over 65 years old. Being disconnected, especially during events, can lead to serious disruptions in reaching these citizens and in delivering critical services to them.”
While it is impossible to consider and plan for all factors, it is essential that planning for resilience, first and foremost, takes into account the various citizen segments and their vulnerabilities. Some tangible actions that could be taken include: Gaining a deep understanding of the demographic makeup of a city and identifying citizen segments and any specific vulnerabilities. ASTDR’s Social Vulnerability Index provides an excellent framework for planners and public health officials to identify and map communities in the US that will most likely need support during a crisis. Similar mapping efforts, even highly simplified ones, would be extremely valuable in cities across the world.
■
Sponsoring and supporting co-creation and co-innovation efforts where citizens and communities become key participants in finding solutions that enhance resilience. Ibasho Café in Japan came into being after the earthquake in 2011. Here the elderly lead resilience efforts and it is an excellent example of citizen and community engagement. Ibasho Café is built around a set of fundamental concepts that enhance resilience including empowering the elderly, community formation, physical and social infrastructure and knowledge sharing.
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Using information technology to gain deep insights into citizens, their vulnerabilities and risks. Information and communication technology also becomes a powerful tool in the innovation and delivery of new services to citizens. ➥
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➥ Information Technology plays a positively disruptive role across the entire lifecycle of a city becoming more resilient.
their own mutually supportive network? To bridge the digital divide, the needed smart phones could easily come from donations.
This architecture would:
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Provide deep insights about the citizen base, their demographic profile, location, vulnerabilities and risks from service disruptions. These insights help make more informed decisions ranging from policy to budget and resource allocation as well as crafting specific response interventions in times of crisis.
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Create and enable new, agile processes that develop and nurture communities, craft solutions from a bottom-up approach and create alternate pathways. HPE’s Social Innovation Platform enables citizens to participate in co-creating new solution in a matter of weeks.
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Develop multiple ways of reaching citizens and create multi-agency, “wrap around” services that are geared towards the specific needs of vulnerable population segments.
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Allow citizens to form their own support networks so that they become “first responders”. In the case of displaced women, why not create a “Facebook” analog so that these highly vulnerable women can form
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Create knowledge repository and share experiences, lessons learned and forming a network that would span multiple cities. It is very interesting to see the knowledge sharing that is taking place between Ibasho Café and other disaster affected areas such as Nepal, the Philippines and Indonesia. Incubate and adopt new technology advances to deliver services in new and innovative ways. For example, developing countries have begun using drones to deliver vaccines and critical medical supplies to remote areas. Why not use the same technology to deliver critical life-support medicines to those impacted during times of crises?
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A common-sense balanced approach is desirable in the adoption of ICT solutions. A large percentage of the vulnerable – i.e. those below the poverty line, the elderly, the indigent – are on the wrong side of the digital divide. Data from a Pew Research study indicates that almost half of the 60 million Americans who do not have access to the internet are over 65 years old. Being disconnected, especially during events, can lead to serious disruptions in reaching these citizens and in delivering critical services to them. Information
“Ibasho Café in Japan came into being after the earthquake in 2011. Here the elderly lead resilience efforts and it is an excellent example of citizen and community engagement. Ibasho Café is built around a set of fundamental concepts that enhance resilience including empowering the elderly, community formation, physical and social infrastructure and knowledge sharing.”
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technology should be utilized judiciously – valuable insights can be gained, new and innovative solutions should be developed, communities must be formed and knowledge has to be disseminated, However, solutions must create alternate pathways, of which many may be manual in nature, to ensure that those “disconnected” and often “invisible” are still served and in a timely manner. As we gear up to make our cities more resilient in an environment where events – weather related disasters, public health incidents, disruptions in supply of food and water, terrorism to name a few – are getting more extreme and more frequent, information and communication technology will be more critical than ever. Finding innovative ways of identifying and connecting with the vulnerable will be critical to making cities resilient. ■
Suparno Banerjee is Vice President and WW Leader for Hewlett Packard Enterprise’s Future City initiative. He is also responsible for developing HPE’s Public Sector strategy and driving client innovation to accelerate growth in public sector. Suparno is a recognized thought leader in Smart City and Digital Government, has led numerous projects globally, and is a frequent presenter to governments worldwide and at key events and forums.
HEWLETT PACKARD
SEPTEMBER 2016
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PERSPECTIVE / WORLD BANK GROUP
Transforming Our Climate-Smart Agriculture Ambitions into Sustained Action BY JUERGEN VOEGELE
I
t’s known that the world will need to feed 9 billion people by 2050. But that is just one part of what is both an immense and complex challenge. There are other factors that need to be considered: Consumption patterns are changing, natural resources are being increasingly depleted, and climate change is impacting farmers, consumers and especially the poor like never before. Let’s not forget, agriculture and land use change are responsible for around 25% of greenhouse gas emissions and are a big part of the climate problem – but also have the potential to be a big part of the solution. So how can we meet one of our generation’s biggest challenges and build the food system of the future— one that can sustainably feed everyone, in every country, every day? How do we make food systems deliver for people and the planet, provide prosperity, reduce poverty and provide a legacy and model for the generations to come? Climate-smart agriculture (CSA) – an integrated approach to managing food systems that delivers increased productivity, enhanced resilience, and a lower carbon footprint—will be a critical part of the solution. Besides delivering those three outcomes, CSA also helps reduce post-harvest losses, biodiversity losses and environmental pollution. Since the Hague Global Conference on Agriculture, Food Security and Climate Change—one of the first ever to make a
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link between these three critical outcomes and which launched CSA into the global conversation--we have come a long way. Farmers, governments, the private sector and scientists have been taking action to make a climate-smart global food system a reality. At COP 21 in Paris, 113 countries pledged to reduce agriculture sector emissions as part of their Intended Nationally Determined Contributions (INDCs). In 2014, UNGA saw the launch of the Global Alliance for CSA, which already has over 144 members, including 24 countries and representatives from across the global food system. There are an increasing number of private sector commitments to take decisive action in supply chains and deliver CSA outcomes. At the World Bank, we are partnering with countries, as well as stakeholders across the food system, in advancing CSA. Earlier this year, the Bank approved the Niger Climate-Smart Agriculture Support project, which is the first Bank project in Africa designed specifically to deliver CSA. We are optimistic that this project will pave the way for a more climate-smart food system in Niger, as well as in the rest of Africa. Our work to advance CSA continues in every region of the world. Last year, 50% of the Bank’s agricultural projects delivered on all 3 CSA outcomes. Currently, 100% of the Bank’s projects are being screened for climate risk and undertaking greenhouse gas accounting to make them more ‘climate-smart’. We are confident that these steps will ultimately
WORLD BANK GROUP
“Consumption patterns are changing, natural resources are being increasingly depleted, and climate change is impacting farmers, consumers and especially the poor like never before. Let’s not forget, agriculture and land use change are responsible for around 25% of greenhouse gas emissions and are a big part of the climate problem – but also have the potential to be a big part of the solution.”
help improve food security, create better livelihoods for farmers, and contribute to efforts to lower the carbon footprint. CSA has already made an impact in many of our partner countries. In Ghana, Senegal and other West African countries, the West Africa Agricultural Productivity Program (WAAPP) has delivered 160 new crop varieties that have helped 5.7 million farmers boost productivity by at least 30%, be more resilient to climate change, and use less fertilizer and inputs, resulting in lower emissions. Alternate wetting and drying rice production techniques in Vietnam helped over 33,000 farmers boost crop productivity by up to 10% while using less fertilizer, resulting in the reduction of methane and nitrous oxide emissions from their rice fields. In Uruguay, the establishment of a national Agricultural Information and Decision Support System (SNIA) and other initiatives are helping both farmers and authorities improve productivity and resilience. With Bank support, 1.7 million dairy farming households across 18 Indian states are adopting better feeding and fodder practices for their cows. Use of local and seasonal green fodder and grain has boosted milk yields, reduced production costs and decreased methane emissions by about 12%, while increasing net daily incomes by nearly 25 rupees per cow. We recognize that the path to CSA will be different in every country and that it is made even more challenging by
limited resources. To enable better decision making, the Bank has developed tools and analytical work to help countries assess opportunities, balance trade-offs, prioritize investments and identify entry points for climate-smart agriculture. Working with partners, we’re producing a series of country profiles that recommend the policies, institutions and best practices for climate-smart agriculture. A global database drawing on data on greenhouse gas emissions from agriculture and land use change not only provides policymakers with actionable data, it also looks at mitigation opportunities and suggests steps for implementing INDCs. Meanwhile, our ‘Climate Smart Agriculture Indicators’ is a tool for policymakers and CSA project teams to monitor CSA results and identify opportunities in the realms of policy and technology. Our ambition is to help each country identify their unique path to increased agricultural productivity, enhanced resilience for their agriculture sector, as well as a lower carbon footprint. Efforts to transition to a more sustainable and climate-smart global food system are gaining momentum. There’s no question that we’ve already made big strides. Let’s commit to going even further and transforming the energy and ambition around climate-smart agriculture into even more action. ■
Juergen Voegele, PhD, was appointed Senior Director of the World Bank’s Agriculture Global Practice on July 1, 2014. Prior to this appointment, he was the Director of the World Bank’s Agriculture and Environmental Services Department. In this role, he provided leadership on the Bank’s activities across sustainable landscapes and oceanscapes, agriculture and environmental economic policy, and risk management and markets. Since joining the World Bank in 1991, Dr. Voegele has held a number of assignments, chairing the Agriculture and Rural Development Sector Board as well as the Environment Sector Board, leading the Agriculture Unit in China and the Agriculture and Rural Development Unit of the Europe and Central Asia Region. In 2008, Dr. Voegele was appointed Director of the Agriculture and Rural Development Department of the World Bank and oversaw global programs for rural poverty alleviation, and agriculture and natural resources management.
SEPTEMBER 2016
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PERSPECTIVE / OXFAM AMERICA
Ending Global Hunger Through Private Sector, Civil Society and Government Collaboration BY RAYMOND C. OFFENHEISER
T
he Sustainable Development Goals (SDGs) mark a renewed global commitment to eliminating poverty and injustice. Goal Seventeen recognizes that 21st century development requires revitalized partnerships for shared prosperity. Oxfam has joined with Swiss Re and the United Nations World Food Programme (WFP) to create a dynamic public-private-people-partnership we call the Rural Resilience Initiative, or R4—a joint effort to help rural families build resilience against climate-related risk. Over 1.2 billion people living in poverty depend on agriculture for their livelihoods. Many live in areas hit hard by rapidly deteriorating conditions associated with climate change. Droughts are more frequent and severe, forcing vulnerable families to pull children out of school for more hands in the field, sell valuable assets, even forego meals.
R4 launched in 2010 to respond to this growing problem, building on the success of an earlier Oxfam program in Ethiopia. R4 combines Oxfam’s experience with community participation and local savings groups, Swiss Re’s innovative risk transfer solutions, and WFP’s global capacity, to offer four risk management approaches in combination: community risk reduction and natural resource management; livelihoods diversification and microcredit; savings; and microinsurance. The core innovation of R4 is that it provides cash-poor farmers the option to work for their insurance premiums on projects that reduce risk and build climate resilience. Farmers improve their food security, insurance companies gain new customers and markets, and safety net programs are strengthened through integration with savings and insurance. We are now testing and scaling up this integrated approach, in the process learning lessons to inform implementation of Goal Seventeen. ➥
“Over 1.2 billion people living in poverty depend on agriculture for their livelihoods. Many live in areas hit hard by rapidly deteriorating conditions associated with climate change. Droughts are more frequent and severe, forcing vulnerable families to pull children out of school for more hands in the eld, sell valuable assets, even forego meals.” 38
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“Farmers improve their food security, insurance companies gain new customers and markets, and safety net programs are strengthened through integration with savings and insurance. We are now testing and scaling up this integrated approach, in the process learning lessons to inform implementation of Goal Seventeen.”
➥ First, coordination is key.
In Senegal, Oxfam and WFP leveraged USAID’s work on index insurance through Feed the Future (Naatal Mbay) to offer USAID’s products to additional farmers through R4. Second, risk management strategies work better together. Farmers with insurance tend to take more risk and invest more in their agricultural production. Regular savings give farmers additional resilience to shocks. Rainfall harvesting helps conserve water in the long run, while weather index-insurance protects against drought in the short-run. And being able to pay premiums in labor rather than cash benefits farmers even when there is no payout—because the projects built further support agricultural productivity. Third, communities that collaborate succeed. When a program includes the landless, single women head of households, and farmers who are better off, it helps participants ensure equal access to common assets through soft peer-pressure. Integration strengthens interpersonal bonds, community solidarity, and social capital. When the whole community has a stake, people are more likely to work together. Fourth, the social protection paradigm is shifting from a model of “beneficiaries” passively receiving benefits, to community members jointly managing social protection mechanisms. In Senegal,
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social protection benefits are now considered a national investment rather than an expense, supporting farmers’ ability to contribute to growing the national economy. Finally, the community benefits when women are full economic citizens. Women often have less access to land, credit, and hired labor, while they remain responsible for the well-being of their families. Yet the data show that when women have access to land and financial services, yields go up 20 to 30% for everyone. R4 enables women farmers to enhance productivity through services like hired labor they could not otherwise afford. Working together, the private sector, local civil society, governments, and international organizations can spur the vibrant and inclusive economies needed to deliver the SDGs. Partnerships can help plug farmers into digital services that can give them spot prices, reliable weather forecasts, and better, cheaper credit, especially for women. Development finance institutions like the U.S. Overseas Private Investment Corporation, which help attract private investment to support double or triple bottom line projects, complement investments made by governments and international aid donors. Partnership-based development is not impossible: the systems exist, and the demand is clear.
These principles have made R4 a success. The U.S. should keep the lessons learned through R4 in mind when planning the implementation of the Global Food Security Act, which became law with overwhelming bipartisan support this July. There is no silver bullet. There is only cooperation and co-creation among every actor interested in ending hunger. ■
Raymond C. Offenheiser joined Oxfam America as its president in 1996. Under his leadership, Oxfam America has grown more than sevenfold, and repositioned itself in the U.S. as an in uential voice on international development and foreign policy.
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SESSION 1
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Session 1: Beyond Aid: A New Paradigm for Global Development SESSION PANELISTS: DIANA L. OHLBAUM, Senior Associate, Center for Strategic and International Studies (CSIS) CAIN PRINCE ANDREWS, Director General of Monrovia, Liberia DANIEL OSUSKY, Standards Development Manager, B Lab MODERATOR: PAUL O’BRIEN, Vice President for Policy and Campaigns, Oxfam America
SITUATION
KEY QUESTIONS
CHALLENGES
With the inauguration of the newly launched Sustainable Development Goals (SDGs) in September, 2105, the mandate is changing to end hunger, poverty and improve human health. Global programs for nutrition, food aid and agricultural aid will now encompass socially responsible involvement by broader stakeholder groups. The global commitment to achieve essential SDG outcomes provides a greater opportunity for involvement by the private sector and entrepreneurs. It also may incentivize a wider demand for increased cooperation, sharing of data, agri-food supply chain tracking and utilizing climate smart agriculture practices, for example. Thus, there is a new emerging array of complex, interconnected challenges to solve. While the SDG’s have been agreed upon by countries throughout the world, more strategic planning and focused work needs to be done to monitor and implement these ambitious goals. Developed countries must substantially change their approach to how they provide development funding and other aid resources. Developing and emerging growth nations must also change the way they act in the sphere of development programs. The SDG’s provide a greatly expanded scope for private enterprise— creating opportunities and investment challenges when collaborations are fostered between the traditional players and sytems in development programs and the newcomers who may bring entirely new insights and technologies which challenge the status quo.
1. How well have private industry and global agencies invested as the major players in development taken up the challenge of the new Sustainable Development Goals? How quickly will change happen? 2. How will funding be coordinated with new players entering the field of international development, and with new voices representing the developing countries? 3. How have the Sustainable Development Goals shifted the conversation and the commitment for food aid and agricultural support programs? Has the introduction of the SDGs actually changed anything? 4. Can the Sustainable Development Goals address poverty in developed countries?
The inauguration of the Sustainable Development Goals requires the realignment of existing development policy and new, innovative approaches, for implementation strategies, investments, local and social involvement and monitoring systems. The panelists noted a generally slow uptake of the spirit of the SDG’s in their respective sectors: Attitudes in the US towards development have historically depended on reciprocity. For example, if funding for aid was to be given to another country, congressmen needed to ensure that US investments in aid would return value to their own constituency base through some sort of reciprocal investment, expenditure or government contract. While progress is being made towards changing the mindsets of US aid agencies and of the congressmen who appropriate money for those agencies, progress is slow.
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At the same time, aid funds are constantly flowing out of developing countries who receive the aid, into US bank accounts, instead of this aid being reinvested in the local ➥
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“Here’s the biggest challenge…the budget to lift the world out of poverty numbers in the trillions. Yet global aid budgets right now are about 150 billion, based on the old fashioned way of counting how much we’re doing for development. Governments like the U.S. are going to have to think differently about what it will take to be a useful partner in achieving these goals.” Paul O’Brien, Vice President for Policy and Campaigns, Oxfam America SEPTEMBER 2016
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➥ developing countries of origin.
American banks are too willing to take in foreign money and act as tools for tax avoidance by private industry. Without additional regulation, this situation cannot change. Generally, businesses are trying to more “sustainably” participate in development aid. Change to existing models of engagement is slow due to a number of obstacles. Businesses have a profit motive; they need to maximize shareholder value. In fact, in the USA, businesses are required by law to focus only on maximizing shareholder value. This keeps the private sector from investing in programs for social good. This issue is compounded by the unclear nature of sustainability. Without defining guidelines and monitoring outcomes for sustainability, it is hard for any business to convincingly claim or substantiate that they are engaged in sustainable development activities. Incentives models have not been defined for assessing the comprehensive, long term value when more sustainable outcomes are achieved.
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aid and funding have historically been coordinated between national governments. However, these national governments often fail to properly address the developmental issues and social needs at a local level. An unwillingness to engage with local stakeholders and local societies opens the door to misallocation of funds and increased corruption. This leads to understaffed schools, unnecessary clinics, and poor outcomes for those who need the aid the most.
OPPORTUNITIES The Sustainable Development Goals promise great opportunity for collaboration on a wider set of issues. Rather than focusing on incremental goals, the SDG’s are ambitious in their scope. They also provide greater equality between developing and developed countries as they work together to tackle complex global problems. Effectively, they are shifting the conversation on redefining development methods while monitoring and encouraging positive outcomes for the SDG’s.
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■ Americans are beginning to realize the true value of development aid. The dialogue is shifting from trying to get something in return for providing development aid to knowing that collaborative aid will benefit the world at large. This shift has put a greater emphasis on encouraging accountability for both providers and recipient governments. ■ The SDG’s make it possible for businesses to enter the field of development. Daniel Osusky’s company, B Lab, has received requests to map their standards to the SDG’s. The effect of standards like these is to establish a “true north” for sustainable private sector engagement. Through the context of the SDG’s, companies funding and development efforts can be re-conceptualized and recognized for corporate social responsibility, integrating a longer term commitment
to humanitarian, economic and ecological value. This in turn helps in the recruitment of company workers who want to make a difference in the world–“millennials”. ■ In Liberia, there has been a strong push for decentralization. This allows local governments more flexibility in serving their constituents. Rather than being constrained by national policy that may not capture all the issues facing a particular community, local governments can come up with novel solutions to local problems. As a result of this, private-public partnerships have become more prominent in Liberia, with local governments working hand in hand with local businesses to augment their policy responses. This model in Liberia exemplifies results of SDG impacts by creating a higher return on social value. ■
“The big thing that the SDG’s do for businesses is that it sets our ‘true north.’ It’s wildly ambitious and wildly comprehensive…They are certainly causing a bigger role for private sector and essentially are putting business in a proper perspective with the world.” Daniel Osusky, Standards Development Manager, B Lab
SESSION 2
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Session 2: Ending Hunger, Achieving Food Security and Improved Nutrition: Milestones and Dimensions On a Path for Feeding the World SESSION PANELISTS: ROGER BEACHY, Director, World Food Center, UC Davis A.G. KAWAMURA, Former California Secretary of Agriculture, Farmer IFTIKHAR MOSTAFA, Senior Agriculture Economist, The World Bank Group PRABHU PINGALI, Director, Tata- Cornell Agriculture & Nutrition Initiative (TCI) HUGH WELSH, President, DSM North America MODERATOR: LAWRENCE HADDAD, Co-Chair, Global Nutrition Report
SITUATION Hunger is an extremely important issue for three reasons, according to Lawrence Haddad: There is a lot of it. 800 million people go hungry each night. 2 billion people are malnourished, especially in terms of micronutrients. 1.9 billion people are obese or overweight, a malnourishment issue. This problem affects every country in the world, not just third-world countries. Hunger leads to death and economic loss. Hunger stunts growth and leads to poorer life outcomes over time. Being malnourished during the first years of life makes a person more likely to be in poverty than someone in the same environment with better access to food. 45% of child mortality for youth under three years old is linked to malnourishment. Poor diet is the number one health risk factor. All of these effects add up, leading to a yearly loss of about 10% of GDP. We know what must be done. Agricultural productivity needs to be doubled, which
will also generate added income by building agri-food and consumer markets. The amount of global food waste also must be reduced. Technology, infrastructure, and incentives need to be improved. For malnutrition, we need to improve social protection programs and school programs. Leveraging social networks can help with uptake and the chance of adoption for improved nutrition. Our understanding of health and nutrition has improved enough to show the importance of breastfeeding, access to clean water, and consumption of healthier micronutrients. In Africa, generally, 40% of children under five years old are malnourished. In Ghana, the headline figure is that malnutrition has been reduced to 19%, which is on track to reduce by half the historic malnutrition rate within 10 years.
KEY QUESTIONS 1. How do we balance agriculture’s role to provide increased amounts of food while also increasing the negative impacts to natural
resources and to climate change? What new solutions are being developed to encourage climatesmart agriculture? 2. What role should private enterprises play in addressing the global nutrition problem? Should they play a part? 3. How can we better understand the cause-roots of hunger so that we can enact more successful policies to mitigate hunger and also improve nutrition? 4. How can greater cooperation between all players be ensured in the fight against hunger?
CHALLENGES Hunger remains a formidable concern throughout the world, in both developed and developing countries. With a growing population, food production must respond quickly. However, maintaining the status quo will not allow the world to feed its people. Changes and new strategies are needed in order to guarantee sustainability. ➥
“In many of the cases, we want to make sure that we pass information to the people who will really solve the problems. If we do this right, we will have engaged the younger generation for the next generation of solutions and we will have engaged those who have the necessary experience in all of the pieces of the puzzle.” Roger Beachy, Director, World Food Center, UC Davis
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➥ Broad headwinds in the fight to eliminate hunger are:
Government mismanagement of agriculture and agricultural relations Without sound regulations and investment in agriculture, governments risk throttling food production. Governments are failing to invest in the infrastructure and educational framework to continue innovation in farming. Climate challenges require better access to water and transitioning geographical areas from desert to arable land – a multi-year task that must be facilitated by government. Instead, governments are failing to partner with the agricultural industry and allowing these problems to go unchecked. AG Kawamura noted that California has made these major investments in educational institutions and other infrastructure with the help of the US government. By doing so, these government investments have encouraged various agriculture industry sectors to come together to solve California’s water shortage problem – making it easier than it otherwise would have been. Resistance to private sector involvement Private investment in solving the hunger problem faces strong opposition. Critics
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claim that private solutions to the hunger problem will be overly focused on profit and will fail to address the problem with a sustainable approach. Organizations devoted to solving the hunger problem prefer receiving grants from companies and working alone, according to Hugh Welsh. However, private companies have more than just money; they have expertise, manpower, and production capabilities that can be leveraged for a more efficient and effective solution. For instance, DSM has partnered with players across the world in order to combat hunger. Its employees help mentor other food production employees. On a grander scale, DSM is building a major food processing facility in Rwanda, using only local inputs. Inadequate data Currently, hunger related statistics are compiled by one major agency- the Food and Agriculture Organization (FAO). Its data, while useful for a broad picture of hunger issues worldwide, does not address the nuances of the hunger problem. It fails to account for nutrition inequality within the household. and does not monitor food diversity, and water sanitation, among other very important metrics. This limits the policy portfolio for politicians, as they are encouraged to focus on food staples, instead of looking at the whole,
integrated societal, health and nutrition picture of hunger and malnutrition issues. Furthermore, the data that is reported is incomplete—only half of United Nations countries self-report their hunger data. Global economic turmoil Global economic turmoil hits the poorest the hardest. For instance, during the 2007 crisis, incomes dropped for those populations who were the most “food insecure.” With this income drop, these people were unable to access food staples, let alone micronutrients or diverse diets. Without safety nets, these at-risk populations will suffer greatly under another economic slowdown, leading to an exponential rise in global hunger. To combat this, the World Bank has provided loans to improve infrastructure and bolster food diversity in the developing world. It has also adopted a three pronged approach to improving food diversity and nutritional outcomes. First, it emphasizes climate smart agriculture, encouraging the planting of crops that have better productivity and can survive in the changing environment. Second, it looks to improve nutritional outcomes by providing resources for access to cleaner water and nutritious food. The third step aims to help farmers bring agricultural crops more easily to market.
SESSION 2
Ending Hunger, Achieving Food Security and Improved Nutrition: Milestones and Dimensions On a Path for Feeding the World
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“If you put on the hat of government…I’m a big believer that agriculture is not broken, it’s actually doing quite well, but it does well as long as the other agencies and other parts of the government understand where we all need to go. When government can recognize that it has to invest in the critical pieces that allow the farmers – big or small, organic or conventional – to exist in the first place. When that government understands its responsibility, we’re at least on the right track.” Hugh Welsh, President, DSM North America
“It’s the balance between caloric intake and micronutrients. Now, you will hear increasingly the Bank and other development partners are not only talking about food security, but food and nutrition security. What we have realized is that if you want to develop a country, or develop a society, at a certain point caloric intake is important, but after that level it is no longer just about food [security].” Iftikhar Mostafa, Senior Agriculture Economist, The World Bank Group
OPPORTUNITIES While hunger is a large and seemingly intractable problem, Lawrence Haddad noted that there is a broad consensus on solving the hunger issue. The steps he discussed are difficult to achieve, but are at least clear. Parts of his prescription have been carried out; for instance, in Ghana, the headline 40% of children that are malnourished has been able to drop to 19% through a loose adherence to his guidelines: Agricultural productivity must be doubled Doubling agricultural productivity will provide enough food to feed the world’s rapidly growing population. At the same time, the farmers that produce this food will benefit financially, as they earn more income from increased demand and production to meet the consumer demand.
This will ensure that increased food production will be financially sustainable and rewarding for farmers. Productivity can be increased through improved technology, better infrastructure, and better incentives for farmers. The economic status of the world’s hungriest has to be improved Without the money to buy food, increased food production will mean little to marginalized people. The solutions to hunger are clear: concurrent economic development and social welfare programs are vital. Social safety nets, like Brazil’s Bolsa Familia, give families the guarantee of accessible food and nutrition.
Nutrition for the world’s hungriest has to be improved While many countries have made strong steps in increasing the availability of food staples, progress on micronutrients remains weak. Better incentives for diversity in agriculture would alleviate the micronutrient problem. If the world can provide cleaner water to those where water is scarce, sickness will fall and overall nutrition will also improve. We also already know that breastfeeding is the key to a baby’s early health. Encouraging the practice of breast feeding infants and ensuring nutrition for nursing mothers will improve nutrition and health outcomes. ■
“We know what to do. There is a blueprint. Some of the details we still don’t know. We don’t know how to implement solutions as cost-effectively as we could. Sometimes we don’t know which item on the menu needs to be selected…But the menu is very strong, the impact evaluation studies are very good – they tell us what works. …I believe, personally…that we can reach this SDG to reduce hunger.” Lawrence Haddad, Co-Chair, Global Nutrition Report
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Session 3: Strategies for Improved Food Security, Food Safety, and Waste Mitigation SESSION PANELISTS: J. BRUCE GERMAN, Director, Foods for Health Institute, UC Davis PINGFAN RAO, Vice President, Chinese Institute of Food Science & Technology, Director, Food Project (China), Future Earth TC WANG, Director, R&D, Anyou, Animal Nutrition Specialist Ltd. WESTON WARREN, Chief Science Officer, Puradigm, CEO, Nanovo MODERATOR: HANS HERREN, resident, Millennium Institute
SITUATION
CHALLENGES
While the developments that led to the Green Revolution were groundbreaking, the system that formed around them needs to change. As per the International Assessment of Agricultural Knowledge, Science and Technology for Development, business as usual cannot continue. Food production, distribution, and consumption must become safer and more sustainable. Food systems are omnipresent, connecting every field of development. Yet, work on the subject lacks synergies. The goals of the Millennium Development Goals (MDG’s) were never properly linked together. With the SDG’s, there is an opportunity to work across fields and save resources by avoiding working on the same issue twice.
While food has become more accessible since the Green Revolution, significant challenges remain in its distribution and consumption. These problems affect the origin of the food chain beginning with the farmer. Farmers face consistently low prices for their foods. In the developed world, food costs represent a very small part of a person’s income and there is constant pressure to reduce that proportion even further. Without increases in food prices in the future, agriculture will no longer be sustainable to be a farmer. Much of the food cost problem is driven by the production and distribution methods. In the past, food costs were higher, but a consumer could easily find out where and how their food was produced. Now, thanks to extensive distribution channels and large farms, this direct connection to the source of food has been broken, allowing for the rise of cheaper food. As a result, the farmer no longer has incentive to ensure quality products, but instead to increase
KEY QUESTIONS 1. How can we make sure that food is consumed safely and with minimal impact on the environment? 2. How can we ensure that food remains available to everybody in the world, but also ensure a good income for farmers? 3. What more do we need to know about nutrition to accurately make new policies include nutritional concerns? 4. How can money be moved from increasing food productivity to preserving food already produced and preventing food waste? 48
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production volume and to sell to as many consumers as possible. The cost of most food is constantly driven down, even as the quality of the food suffers. Consumer safety is seriously threatened. With such cheap food, it is difficult for consumers to maintain a healthy diet. As developing countries begin to consume, en masse, more new, cheap, less sustainable livestock production will become more prevalent. For instance, in China, a diet which was once dominated by vegetables has become increasingly dependent on meat. This in turn has a profound and negative effect on the environment and climate change. With increased production volume of food, it has become less important to consider what happens to post harvest food after it leaves the farm. Although this post-harvest food is bound to reach the consumer, much of the food is wasted during transportation, and display in retail stores, in food service, and at home, leading to tremendous inefficiencies and increased food waste. ➥
“Business as usual is not an option. By business as usual we meant basically the development that led to the Green Revolution. A lot of good things have been achieved but a lot of lessons have been learned, or should have been learned. We now need to change gears and move to more sustainability.” Hans Herren, President, Millennium Institute
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Strategies for Improved Food Security, Food Safety, and Waste Mitigation
“Fifty percent…of all food, grains, nuts, fruits and vegetables go bad, spoil rot, before they hit the dinner table. Our technology is able to preserve food and retard decomposition…For example, considering the largest grocery store chain in the US, just giving them three days’ shelf life extension on their produce will save them 1.1 billion dollars a year.” Weston Warren, Chief Science Officer, Puradigm, CEO, Nanovo
“If you’re talking about food as a basic nutrient, the price of f ood will never go up. But food has other properties; food will give you pleasure...food can give you health. If we can power our food with these two properties, then people should pay a lot of money for that.” Pingfan Rao, Vice President, Chinese Institute of Food Science & Technology, Director, Food Project (China), Future Earth
OPPORTUNITIES Progress on better nutrition, better consumption, and better distribution can be made in three key ways. More expensive food According to Bruce German, the key to ensuring the sustainability of the farming profession is slightly increasing food prices. Citizens of the developed world spend only a small percentage of their money on food and nutrition. Increasing that proportion slightly would allow farmers to earn more profits, especially farmers in developing countries. Pingfan Rao noted that essential foods, staples must remain cheap for the benefit of consumers who rely on them. However, foods that are promoted on the basis of their health or pleasure benefits should require a premium, providing a window for revenue expansion. Increased consumer awareness Consumers need to have a better understanding of where their food comes from. According to T.C. Wang, once consumers become aware of what they put into their bodies, they will make better choices as to the quality and nutrition benefits of the food they eat. To provide this information, more money must be devoted to nutrition research. Major steps have already been made; in the last few decades, scientists have established which
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nutrients are necessary for human health. Scientists now have the opportunity to go further with technology and do research on nutritional choices on the individual level. In the same way music and transport have been personalized, nutrition can be personalized too. Increased funding for research If research funding is shifted to postproduction, as opposed to increasing food production, there is significant opportunity to make a difference and innovate. As Bruce German noted, money invested in the pharmaceutical industry has yielded amazing results. Doing the same in the
fields of food production and nutrition would do the same. Improved technology has the potential to reduce food waste. Weston Warren’s company Puradigm, has pioneered a method to keep food fresh during transport and display. Such technology increases efficiency and ensures that areas with limited distribution infrastructure and poor storage capabilities can preserve the majority of their food for longer periods of time. Warren also noted that his method of preservation brings tremendous cost savings. For example, one major grocery chain in the US could save 1.1 billion dollars with a shelf life extension of just three days. ■
“We are bringing in information so farmers can manage their fields better. It’s increasing the level of production more efficiently and targeting where fields need input. There are multiple soil types in a field and there are dynamics that change, based on different weather conditions or different applications. By measuring that data on a real-time basis, we can create a precision ag environment.” Lanny Faleide, President & CEO, Satshot
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Session 4: Achieving Sustainable Agriculture SESSION PANELISTS: MINOS ATHANASSIADIS, Senior Director, Agrian Inc. DANIEL L. SCHELLENBERG, Post-Doctoral Student, UC Davis STEVE SHAFFER, Environmental Consultant, American Farmland Trust SHARON SHOEMAKER, Director, California Institute of Food & Agricultural Research (CIFAR) WENQING ZHAO, Institute Deputy Director, Beijing Tianchen Cloud Farm Co., Ltd. MODERATOR: DANIEL VAN DER LELIE, Global Director, Biosolutions, R&D, FMC Corporation
SITUATION Sustainable agriculture can play a pivotal role in the second SDG to “End Hunger”, and also the achievement of the rest of the seventeen SDG’s. By 2050, there will be 9-10 billion people living on the planet; to accommodate them, food production must double. Even now, 3.5 to 5 million children are suffering from malnutrition. In some countries, as much as 45% of children suffer from malnutrition. In the case of primary school aged children, 66 million go to school without a proper breakfast. Even in the United states of America, as many as 25% of children cannot eat breakfast and depend on school lunches for their nutrition. Malnutrition is a nuanced problem, encompassing the range of starvation to obesity, and a lack of access to micronutrients. Producing more food by current methods will certainly destroy the environment and is unsustainable. Given this complex problem, a solution must include: Better collaboration between academic disciplines and farmers, to create comprehensive solutions that address real life conditions.
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Profitable technologies and implementations, adding value for farmers and giving them a reason to invest and “buy in” to the solutions.
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Increased accessibility to resources for more sustainable farming, making sustainable farming cheaper and easier.
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Fulfilling these requirements will be challenging. A constant drive for lower prices disrupts the value chain for the farmer, a condition exacerbated by the decreasing number of farmers and the increasing impacts of climate change. These issues can only be surmounted through “buy in” from all potential stakeholders, ranging from farmers, to academics, to the private sector. Technology and new practices have an important role to play for sustainable and climate-smart agriculture. Currently, farmers must depend on unsustainable farming practices to make a profit. However, with recently created technologies and practices, that incentive is shifted, as new technologies and practices become more accessible to farmers, it will be easier to profit from more sustainable agriculture practices.
KEY QUESTIONS 1. How can we feed the ever growing world population and make sure food reaches malnourished people? 2. How can sustainable food production become profitable for farmers? 3. What will make farmers change their farming habits and consumers change their consumption habits? 4. How can we ensure that new technologies are accessible to the people who would benefit from their use? 5. How can we enhance both large scale and small scale farming, without ruling out any solutions?
6. How can we ensure a collaborative process, including farmers, academics, and businesspeople?
CHALLENGES With an unprecedented rise in population, food security is increasingly important. A key component in ensuring food security is the inclusive development of new practices and technologies. A major concern shared by almost all the panelists was the isolation that stakeholders face. Even as the various disciplines come together, they must face the larger problem, the disrupted value chain that faces farmers. Three broad challenges facing sustainable agriculture are: Unprofitability of sustainable farming A constant drive for lower prices has reduced the profit margin that farmers enjoy. This makes farming a less attractive profession, as Saskia Visser pointed out. As a result, farmers become an endangered species, reducing the scope for dramatic change in agricultural. Furthermore, farmers are reluctant to change practices, especially if there is no profit motive to change. Breaking the silos The only way for progress on the issue to occur would be through greater collaboration. A solution built on resources available to a university in research conditions cannot be necessarily applicable to a farm setting. Similarly, a solution created solely in the field of agriculture by the farmer may not take into account the critical scientific nuances that research universities can bring. ➥ SEPTEMBER 2016
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Achieving Sustainable Agriculture
“When it comes to farming, it’s about all farmers. We need all kinds of farmers and all kinds of technologies to meet the goals… We actually do want to encourage and talk about all the different technologies and see how we can integrate them. Because the reality is that the Earth is a very heterogeneous place. Not all the soils are the same, the climates aren’t steady. We need to consider all farmers and engage them.” Daniel L. Sschellenberg, Post-Doctoral Student, UC Davis
“In China…if you talk sustainable, balance between people, planet and plant with the farmers, it doesn’t make sense. They will not listen to you. You need to prove that sustainable means that you can make a profit. If you as a farmer have a low input for the materials and chemicals, you can get more quality food, and a better price. Thirty percent of land is transferred to large scale [farms]. It will be a good time for new technologies to get into the Chinese market.” Wenqing Zhao, Institute Deputy Director, Beijing Tianchen Cloud Farm Co., Ltd.
➥ Managing changing needs and constraints Global food production must increase due to the rising world population, yet at the same time be responsive to the threat of climate change. Much of the world’s good farming land is close to cites and is under threat of encroachment by the very cities that it feeds. Solving this problem will require a careful balancing of farm and urban needs.
OPPORTUNITIES A number of technologies and practices have been developed and have been tested, offering a chance to address the problem of agricultural change. As Daniel van der Leile noted, such technologies are needed to implement resilient agricultural practices. Fertilizer management According to Daniel van der Lelie, fertilizer is often overused, leading to reduced agricultural yields. In China, excessive fertilizer use had led to high phosphorus levels, preventing crops from reaching their full yield. For example, one new fertilizer solution is demonstrated by the application of a micro organic treatment by Azotic Technologies which
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allowed crops to overcome poor soil quality. When compared to regular fertilizer, 40 more bushels were produced for the same acreage. Electromagnetic water conditioning In Rajasthan, water access is a serious challenge. In this case, the local raja provided 10 hectares of land for experimentation. This land was filled with excess salt, due to the brackish water that had been absorbed into the soil. However, through electromagnetic water conditioning, the water quality increased significantly, reducing the salt levels in the fields. Grain production increased, as did diversity and overall output. This entire treatment required minimal amount of electricity, as the process was powered through the reaction of zinc and copper. Micro-irrigation Traditional irrigation and fertilization is unsustainable in drought-stricken California. Producing less volume of agricultural product is not an option for these farmers. Through microirrigation techniques, farmers save water and provide water to only the plants that need it when they need it. Fertilizer can be applied at a reduced rate as well, with dispersed applications over time.
Partnerships between universities and farmers The traditional model of research and creation of solutions is: a university studies the problem and creates a solution in lab conditions. Following successful development, the solution is pushed to farms, through a network of private and public partners. However, in this model, farmers have little input on the solution, and receive an end product that does not fully meet their needs. However, if data is collected and shared with farmers, as in the case of Agrian, the solution can be much more inclusive and targeted for the needs and uses of the farmers. Rumiclean According to Daniel van der Lelie, This feed additive, described by Saskia Visser, lowers the methane output from livestock production and dairy production. At the same time, it increases milk output. However, farmers were reluctant to use this additive, as it represented an additional cost with minimal benefit for the farmer’s bottom line. Visser’s reasearch explored possible options to make the additive more attractive and discovered that bundling the additive with carbon credits would allow the farmers to make a greater profit from its use.
SESSION 4
Better data on farmland In order to better advocate for farms, it needs to be clear how essential farming is to consumers. To make people more willing to pay more for sustainably priced food, consumers will have to know that is the food they eat can be verified as sustainable, and to know where their food comes from. Policy makers need to know what land is best for farming and understanding where the trade-offs are for using that land instead for city development. Agrian Ic. Specializes in agronomy, bringing a data driven approach to farming. They test soil over a wide range of environments and note patterns through their cumulative data. This data can be used to comply with regulations, apply more precise amounts of fertilizer, and pick the correct products to apply to a field.
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Internet platform for farming tools, fertilizers, and more Cloud Farm began as a company primarily focused on fertilizer, but found that farmers needed a one-stop shop for farming products. By cutting out the middleman, Cloud Farm’s online platform makes it easier and cheaper for farmers to access products they need. Cloud Farm couples its online presence with a larger offline presence (70% of all employees work on the offline side of the business). Through this channel, Cloud Farm can mentor farmers and provide targeted and nuanced solutions. ■
“We must identify those most highly productive agricultural lands. We must protect them for future generations. We must then ensure e that farmers can stay on that land. And then we must incentivize farmers for improving their environmental footprint to beneficial or best management practices. That takes data, that takes social networking.” Steve Shaffer, Environmental Consultant, American Farmland Trust
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Session 5: The Garden and The Banquet: Cultural Meaning of Farming and Food SESSION PANELISTS: A.G. KAWAMURA, Former California Secretary of Agriculture, Farmer JEFF PFITZER, Program officer, Benwood Foundation BISHOP WILLIAM SWING, President and Founding Trustee, United Religions Initiative (URI) MODERATOR: WOODY TASCH, Founder and Chairman, Slow Money Institute
KEY QUESTIONS
SITUATION There is a crisis of connection, or affection, expanding in modern day culture and society. According to Woody Tasch, affection, which is a deep connection between the people and the place they live, is faltering in the face of growing financial institutions and the pace of the modern economy. As a result, counterproductive practices and conditions threaten the future of society. Monoculturalism, driven by a desire for greater productivity and profit, has supplanted diversity. Similarly, transactions have replaced relationships, leading to a convenient, yet impersonal way of life. The result of these switches is an estrangement from other people and the food that we eat. Because of these estrangements, we fail to note the quality of the food we eat, the efficiency of its production and distribution, and we miss knowing about the people who go hungry from a lack of food and nutrition. The question is: how can we remain connected as people and protect food and land, in the face of the financial juggernaut of the new economy? Reversing the current trend will be difficult, given its magnitude and ubiquity. When affection is inversely proportional to the velocity of money and the scale of financial institutions, policy makers, consumers, and producers need to strike
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a balance. A sustainable solution will have to be community based with food that is locally produced. Given this unique prescription for global change, a myriad of solutions are possible—and necessary. Already, solutions are coming together. Communities are reemphasizing their role in food production and distribution, allowing people to connect again. The panelists see the potential for greater connection in emerging technologies, such as block chain currency and the cloud, and traditional communities, like faith-based groups and food banks. Joining these two will require innovation, but there is a clear abundance of that in the effort to rebuild our connections.
1. H ow can we continue to enjoy most of the benefits of the current food production and distribution system, but also make meaningful changes to ensure that our consumption and production is sustainable? 2. H ow can we return to cultural connections in the face of modern convenience? What steps can policy makers take to encourage such a shift? 3. H ow can consumers become more conscious of where their food comes from and ensure that they consume high quality food? 4. W hat will allow small scale farming and trade to become a competing player in a large company dominated market environment? ➥
“Affection is inversely related to velocity of money and scale for financial institutions…How can we remain connected as people? How can we protect our food, and how can we protect the land in the face of money that is moving faster and faster? Our financial institutions are getting larger and larger and divorced from the things we care about.” Woody Tasch, Founder and Chairman, Slow Money Institute
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CHALLENGES
➥ The largest challenge facing the consumer-producer relationship is connection. That is, consumers no longer know how their food is produced, where it’s produced, and who produces it. The abstraction caused by the scale of food companies and financial institutions prevents the connection. Each panelist noted different facets of this overarching problem: Opaque financing and high speed transactions The size of financial institutions and the speed they move at are impossible for the average consumer to follow. This inability to follow funding makes it extremely difficult for consumers to be engaged with the companies that produce their food. Having no consolidated and transparent means for investing in food production options leaves consumers at the mercy of financial monoliths lending to large agricultural companies. For Woody Tasch, this keeps the consumer from having a connection with his or her food and the people who produce it. In addition, there is strong distrust with respect to the ability of large companies to behave sustainably in financing and producing food. Options vs. meaning Bill Swing sees the symptoms of the connection crisis differently. In the past, food had meaning, especially in the context of religion. Judaism has its kosher food, 56
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Islam has halal food, Jainism considers all living things as sacred, and the Sikhs share their food with any who need it. In this sense, food had a greater value than simple nutrition; it had social and spiritual meaning. In the religious context, food meant memory, sacrifice, community, thanksgiving, and blessings. However, with the speed of food consumption and production today, there is no time to engage in any of the above. Difficult business environment Jeff Pfitzer works with the local food economy sector to help farmers become financial sustainable. The food production economy is biased towards large companies, squeezing the smaller and more community-rooted farms out. Countless regulatory barriers mean that any food producer must have the resources to ensure legal compliance. Big box stores work easily with large producers/ distributors simply due to reasons of scale.
Lack of awareness Consumers simply don’t know how their food is produced and distributed. This is a problem in two senses. First, consumers can’t possibly buy all the food that farms produce, leaving significant quantities to go to waste. Consumers typically don’t know how their purchasing decisions may encourage more sustainable options that might lead to less food waste. Furthermore, because consumers aren’t fully aware of farming practices, the occupation of farming is becoming rarer and rarer. As less people join the industry, policy is ignorant of the industry’s needs and the valuable knowledge and experience that farmers hold, is being lost.
“Food is not just food. People used to go where food was sacred… Today we eat so fast that there’s not a chance to do the sacrifice, there’s no chance to do remembering, there’s no chance to do the thanksgiving. It takes time to deal with food in a sacred manner.” Bishop William Swing, President & Founding Trustee, United Religions Initiative (URI)
SESSION 5
FOOD
OPPORTUNITES Despite the many facets of the problem relating to the loss of food and farming connection, new solutions are growing. Communities are coming up with new approaches to reattach themselves to food production. While the financial system seems untouchable, new investments in food, agriculture and farming has begun to flow in alternative and novel ways. Over the course of the panel, a few types of solutions became apparent:
year. Given the status of these community centers as bedrocks of local and social centers, these institutions have a unique opportunity to add “community” back into food. By starting community farms and gardens, they can bring their congregations into the food production sphere. They can provide food supplies, allowing people to learn more about where their food comes from, and to participate in food cultivation, and foodrelated activities in a collaborative setting.
Crowdfunding One novel way of ensuring funding for small food producers is crowdfunding. The primary advantage of this method is its independence from the larger financial system. In Colorado, the Slow Money Institute organized an experiment- they featured 8 local organic food enterprises and invited people to invest in them. The Slow Money Institute only allowed donations in bitcoins, the largest block chain currency. As a result, none of the investments had to flow through a major bank or clearinghouse, allowing for democratized investment. 56 thousand dollars were raised.
Social media/ technology Social media and technology promise greater engagement for consumers and easier workflows for farmers. Social media can educate the public on the food they eat in an accessible and ever-present format. Farmers can use the medium to reach out
New roles for community centers Mosques, churches, and temples have always been centers of community. People congregate there to worship and engage in community activities throughout the
to potential future farmers and encourage them to join the essential farming and agricultural profession. Technology can help even the playing field between small farms and their larger competitors. Online selling can allow small farms to efficiently connect directly to the consumer, rather than relying on expensive large scale distribution networks. Food Banks+ Food banks are established food distribution centers. With small farm partnerships, community food banks can serve a wider set of clients. Furthermore, farms and stores can avoid food wastage by sending excess produce to food banks. This can build awareness and ensure that food scarcity and hunger is not needlessly created. ■
“Ultimately, all culture is local, and the most impactful actions are also local. We began working in the community to understand where those relationships were breaking down. We reconnected the faces and functions of local ag with the community…In the last year or so, local ag has become viable for fiscal investment… They’re all working to put down deep roots in the community, and they not only participate in an economically conscious business model, but also a socially conscious relationship, with the land and community as well.” Jeff Pfitzer, Program officer, Benwood Foundation SEPTEMBER 2016
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HEALTH
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SESSION 1
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Session 1: The Healthy Environment: Environment, Infection and Health SESSION PANELISTS: RYAN DOYLE, General Manager, oneC1TY Nashville MICHAEL GRAZIANO, Founder, small-r LEE LORENZEN, Staff Researcher, Department of Pharmacology, UC Irvine WESTON WARREN, Chief Science Officer, Puradigm and CEO, Nanovo MARY ANN WAMERDAM, External Regulatory Affairs Leader, Global Stewardship and Innovation, The Clorox Company MODERATOR: DENNIS GRIMAUD, CEO, Diatherix
SITUATION The old paradigm for treating disease and dealing with infection is becoming less and less useful. For instance, antibiotics were a major breakthrough in medicine during the 20th century. However, as time has progressed, their effectivity has decreased through overuse and misuse. New drug resistant strains of bacteria have developed, threatening the lives of millions of patients. Lifestyles have changed, keeping people inside buildings and inactive. While such a lifestyle is convenient and protective from the dangers of the outside world, it leaves people susceptible to disease and adverse health conditions. Yet as activists attempt to effect change, they face an uninformed public and institutional inertia. The institutions of medicine and animal health are slow to change their use of antibiotics and harmful practices. While practices are slow to change, western medical professionals have begun to consider the health problems of the developing world. They face unresponsive communities and unfamiliar partners in their work. However, solutions to these issues are forming and appear promising.
KEY QUESTIONS 1. What kinds of global problems hinder the growth of a healthy society, especially in terms of lifestyles and entrenched practices? 2. How can concerned health professionals and citizens change the status quo of medicine and health worldwide? 3. How can new technologies be delivered to the people who need them in a way that encourages their uptake? 4. What will drive parties working on health issues to work together?
CHALLENGES Proliferation of drug resistant bacteria and viruses As Dennis Grimaud pointed out as he opened the session, medicine has helped to fight bacteria, but irresponsibility has bred diseases that are incredibly hard to fight. Diseases like carbapenemresistant Enterobacteriaceae (CRE) require intensive, often unsuccessful, treatment. Despite knowledge of this issue,
industry has not made its practices more sustainable. Food production companies still treat their animals with a cornucopia of unnecessary antibiotics, providing an opportunity for drug-resistant bacteria to flourish. The danger posed by these bacteria is raised by changing lifestyles. The average person has become more sedentary and less likely to go outside. As a result, according to Weston Warren, the average person exposes himself to more dangerous bacteria and fails to develop the necessary immunities. Lack of awareness While the severity of health issues increases, the public remains ignorant. As Michael Graziano pointed out, the improper medical treatment of animals has led to an uptick in drug-resistant bacteria. However, the consumer lacks the information to make an educated purchase. In this vacuum companies can seize on a minor data point and spin the argument in their favors. As a result, while data exists to show that there is a problem, it does not motivate appropriate action. The lack of public education on this ➥
“We’re trying to take on the problem by not only improving the water supply and creating functional products, but also helping address in a very small way some of the issues of opportunity. Because if you can improve the health and give financial opportunity as well, I think you can improve a lot of lives.” Lee Lorenzen, Staff Researcher, Department of Pharmacology, UC Irvine SEPTEMBER 2016
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The Healthy Environment: Environment, Infection and Health
“In the last 200 years, as a human race, our lifestyle and occupations have drastically changed. For thousands of years, mankind has been an outdoor agricultural society. What are we doing now? We’re indoors all the time. Our indoor environment is one of the most toxic and hazardous environments that we can have. Our technology at paradigm, called PCO technology…what this is able to do is duplicate what nature has done.” Weston Warren, Chief Science Officer, Puradigm and CEO, Nanovo
“That’s what community development is all about. We’re creating better places for people to interact... our challenge is to translate spaces to drive people to make emotional connections. So what we were trying to do was create communities that change the way that people live their lives, giving accessibility thorough services, making it more walkable.” Ryan Doyle, General Manager, oneC1TY Nashville
➥ issue limits policy responses because political leaders never realize that there is a problem without public agitation. Meaningful change is stymied. Also, when solutions are available, a lack of awareness consigns them to failure. It prevents companies with solutions from joining together with the necessary stakeholders to promote the use of their product. Knowledge management Mary-Ann Warmerdam noted that necessary information is not being passed down to children, part of an overall breakdown in communication. Essential practices, like washing hands, fail to reach young people today. This leaves them more susceptible to disease and more likely to spread those same diseases. In her work in Latin America, she found that when young people were not engaged in her group’s development work, changes never stayed in place. The breakdown in communication affects academia as well. While one discipline might have found some solution to a problem, they often fail to share it with other groups studying the same problem. Instead of working together, researchers work in parallel, slowing down the discovery of new solutions. Academic silos prevent important advances from happening.
OPPORTUNITIES Graziano sees opportunity in further outreach to the community. As a filmmaker, he has seen the positive effect 60
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that his work has had on the discussion of drug resistant bacteria. According to him, if more consumers understand the dangers of the current modes of production, they can help change the system. More outreach, through any medium, can help make the market at large find out about new solutions. As stakeholders find out about innovations, they can put them to use in partnership with the creators. Warren’s companies, Nanovo and Puradigm, take on the issue of the ubiquity of germs and disease. His products allow a safe and natural way to eliminate dangerous pathogens. One simple device releases bipolar ions, imitating the effect of lightning. This steady stream of ions wards off undesired germs. Warmerdam’s work with Clorox’s corporate responsibility provided her with new insights on community engagement.
Initially, her team arrived in Peru expecting to have their work stand on its own merit. Instead of immediately adopting the efforts that she tried implementing, the communities largely ignored her and her team. Unable to engage in this manner, her group began to look for a local partner. When they found local NGO who was already a “known quantity”, their experience began to turn around. Partnering with a community based organized organization allowed her team to connect with the communities and actually effect change. Her team was able to install water purifier (chlorine) dispensers throughout the community, encouraging its residents to use it. As the partnership came to fruition, her team saw an 85% reduction in disease. Dr. Lee Lorenzen has developed a new type of water to rejuvenate cell membranes. As his wife was dying, he had nearly exhausted every possible treatment method. Finally, he took her to a healing spring, and she improved quickly. According to Lorenzen, this water is structured differently from most water. His “clustered water” forms in a hexagonal shape, making it ideal to rejuvenate cell membranes. He noted that his product has been implemented in countries like Togo and has led to better health outcomes. The government provided his water, but also coupled it with financial opportunity, allowing participants to get to work as they became healthier. ■
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Session 2: Frontiers of Health Data Analytics SESSION PANELISTS: KELLY ALDRICH, Chief Clinical Transformation Officer, Center for Medical Interoperability MARY MIRABELLI, Vice President, Global Healthcare Services, HP Enterprise Services, LLC REMY SZYKIER, Managing Partner, Aegis Health Security MODERATOR: NIALL BRENNAN, Director and CMS Chief Data Officer, Centers for Medicare and Medicaid Services
SITUATION
KEY QUESTIONS
CHALLENGES
The private sector has generally embraced a data driven approach to decision-making, achieving greater productivity and efficiency. Yet, medicine lags far behind in implementing analytics in diagnosing and treating disease. Data could be used to provide personalized diagnoses to patients and accurately treat their illnesses. Medicine’s dataaverse strategy has left patient records fragmented and often inaccessible to those same patients. Without a complete understanding of their own medical data, patients are effectively cut out of their own medical decisions. Solutions are emerging, as health professionals and technology companies partner up. They are linking the world’s data into useable formats for easier treatment and diagnosis. As advancements are made, it becomes easier for doctors to target their treatments, resulting in precise use of medicine and a reduction in unnecessary procedures. Even as medicine becomes more personalized, public health officials can use aggregate data to easily track epidemics and discover “patient zero.” Health trends could even allow for early detection of epidemics, allowing quick and effective policy responses. Data in medicine also has the potential to give patients more power in their own treatment.
1. How close is medicine to truly adopting data and analytics as tools to address health problems? 2. How can patient privacy be balanced with more freely available information on patient health? 3. How can data be used in an aggregate sense to effectively address epidemics? 4. What will drive health professionals, data scientists, and patients to cooperate in creating the database necessary for analytics to be useful? 5. Why have medical professionals been so slow in incorporating data analytics into their healthcare toolset?
“The frontier… may actually be a relatively low bar.” Incorporation of data analytics into healthcare practice has just begun, and as a result still faces significant headwinds. There are two broad challenges in the field of health-related data analytics: an extremely fragmented data set and security. Solving either issue means striking a careful balance- too much connectivity can lead to insecurity and a closed-off system can’t be used in data analytics. According to Kelly Aldrich of the Center for Medical Interoperability, doctors use countless medical tools every day, but fail to leverage their true potential. Every time a doctor or a nurse measures blood pressure or takes an x-ray, that is a chance for data input. ➥
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“If you look at how much your personal health and wellness is defined, it’s not the data that sits in your EHR or in a clinical setting, it’s everything about you as a holistic view of that person, that’s outside of the healthcare clinical setting: where do I shop, what am I eating, what’s my transportation? There’s all of this data that’s not within the clinical setting but also needs to be considered when you’re looking at a holistic view of the individual.” Remy Szykier, Managing Partner, Aegis Health Security
SESSION 2
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Frontiers of Health Data Analytics
“We are re-inventing…the blue button program for Medicare beneficiaries…we’ll actually permit beneficiaries to not only download a machine readable version of their healthcare claim experience. But also give you the power to share that information, to be in control of your own information and to choose who you share that information with.” Niall Brennan, Director and CMS Chief Data Officer, Centers for Medicare and Medicaid Services
“I think the data sets that we’re going to need will continue to expand if we really want health outcomes...And I do think that we’re on that trajectory to say ‘I ultimately want personalized medicine’… if I’m a diabetic, I want it to be about me. I think there are glimpses of that happening.” Kelly Aldrich, Chief Clinical Transformation Officer, Center for Medical Interoperability
➥ However, most medical instruments
are closed off; they do not communicate with each other. This leads to medical silos, preventing a complete picture of a patient’s health. Doctors are forced to look at disease on a case-by-case basis, unable to connect the dots to see patterns between patient cases. Analytics does exist in medicine, but it is limited to real-time care. A doctor can only treat a patient that is in front of him. Without the patient’s file, he cannot access any information that might help him predict what might be affecting his patients ahead of time. These data restrictions leave the doctor perpetually one step behind. Even as aggregate data is unavailable to doctors and other healthcare professionals, patients have limited access to their own health information. While there has been a recent push for greater patient empowerment, the result has been false empowerment. For instance, patients can now rate their doctors and pick the best ones based on that rating. Yet, this hardly puts patients in control; they still need the doctor to make a diagnosis and treat their symptoms. Due to the fragmentation of health data and the various owners that control one patient’s health data, it is nearly impossible to form a clear picture of one’s own health. Without this broad view, patients cannot effectively advocate for themselves.
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If data becomes more open, a new problem will arise: security. Even now, hackers have made off with millions of health records from insurance companies. Open data implies ease of access for anybody who wishes to use it. Healthcare professionals would be able to apply sorely lacking analytics, but would leave the door open for hackers to steal patient histories. As Mary Mirabelli, from HP, noted, health information is valued much more highly than even credit card numbers. Health information can be used to make fraudulent claims, buy medical equipment, and improperly access drugs. These hackers on average, remain in a system for over 200 days before being detecteda massive window for crime.
Yet, increased security makes the barrier for the use of analytics too high. Nurses who have to navigate through an arcane system of data forms and passwords give up and use their phones to transmit patient information. Aldrich ran a study asking nurses to write down every time they were inconvenienced by technology in a single day; she received over 8000 complaints. By using unauthorized means of communication, the nurses prevented data from being collected and eventually used. Even more importantly, they used unsecure systems and threatened patient safety.
SESSION 2
OPPORTUNITIES The field of healthcare analytics is just opening up, presenting a wide swath of opportunity. Data connections can be built, secure systems can be implemented, and policy can be made. Each of the panelists brought their own contributions to the table, advancing the field of healthcare analytics. Niall Brennan works with the Centers for Medicare and Medicare Services, a department host to a grueling paperwork process. The sheer mountain of paperwork often deters patients and their families from collecting their medical histories and being involved in their own treatments. He has helped to improve the Blue Button system, improving patient accessibility to medical records. Various healthcare providers, insurance companies, and others have signed on to allow patients to easily download copies of their healthcare information. Kelly Aldrich’s Center for Medical Interoperability is making steps to break the information silos that constrain medical data analytics. The Center brings together professionals to work on integrating health systems. Vendors, research and development scientists, and practitioners engage and exchange ideas and work towards a more connected medical world.
HEALTH
Remy Szykier has been working on creating a predictive health index which brings in genetics and epigenetics. The result will be a more accurate model of disease spreading through populations, allowing public health officials to respond proactively to potential health crises. Past approaches have relied on traditional methods of data collection, such as surveys and hospital records. In her method, she attempts to increase the number of touchpoints an individual can relay information to researchers. Key to this strategy is the mobile phone, an easily accessible and omnipresent device. As the data builds, policy makers can create better policy, medical professionals can allocate resources more efficiently, and public health officials stop epidemics before they happen. Mary Mirabelli spoke about the revolutionary data projects that HP
has undertaken. At the Department of Veterans Affairs, they have implemented real time tracking of doctors and patients. This allows patients to keep tabs on their doctors and vice-versa. On a larger scale, HP is working on creating a global realtime health system. Using a 3G or 4G enabled device, a user can input health data from and tie that information to geography. This mapping of health data is essential to understanding how a disease is spreading. When two users cross, it becomes possible to determine that one of them is the vector for the disease; patient zero is much easier to find. Geographic data also allows HP to take account of the various weather conditions around an individual or other external data sources. HP is working with the military to implement this and to learn how to keep the system secure. ■
“And so we will establish honeypots that allow bad cyber guys to search around its all fake data, but it allows us to understand how they look, how they search, what they’re looking for. I think [cybersecurity] is a huge issue, I think we’re getting smarter around the world on how we have to handle it.” Mary Mirabelli, Vice President, Global Healthcare Services, HP Enterprise Services, LLC
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Session 3: Strategies to Achieve Health: Advanced, Developing and Underdeveloped Regional Strategies SESSION PANELISTS: NICK ASSAD, Senior Vice President, Business Development, CirrusMD JOXEL GARCIA, Executive Director, Cancer Prevention and Control Platform, University of Texas MD Anderson Cancer Center ALEX PHILP, Founder and CEO, Upstream Health HERMAN WILLIAMS, SVP and Chief Medical Officer, RegionalCare Hospital Partners MODERATOR: ROBERT DITTUS, Associate Vice Chancellor for Public Health, Vanderbilt University Medical Center
SITUATION With the recent adoption of the Sustainable Development Goals (SDGs), issues such as poverty, hunger, and especially health have taken the forefront of international discussion. Through SDG 3, which was created in an effort to ensure healthy lives and promote well-being for all ages, companies in every sector are hoping to elevate the level of health for every citizen to the highest level possible. Though we are all working toward the same goal, the United States’ convoluted healthcare system makes it difficult to increase the effectiveness of its services or even provide basic care to its citizens. Rather than focusing on the positive aspects of health, the U.S. healthcare system tends to be highly diseasecentered, with an emphasis being placed on treating illness after onset rather than preventing it. Indeed, health is defined as the state of complete physical, mental and social well-being, not merely the absence of disease or infirmary. Therefore, it is critical that the U.S. take in a broader view of health that encompasses both treatment and prevention. The determinants of health go far beyond healthcare delivery. Factors such as genetics, the environment, and social elements also affect a person’s well-being, and thus require a much wider scope of
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CHALLENGES healthcare services to maintain a person’s optimum level of health. By expanding the scope of health to include prevention, psychiatry, clean air and water and a plethora of other care systems, people can increase their overall quality of life. Though there are many regional strategies being developed to tackle the world health crisis, there is no universal solution to bettering the health and well-being of every single country in the world. Therefore, it is imperative that every region’s unique situation be researched in an effort to generate a variety of solutions tailored to that area’s health needs.
KEY QUESTIONS 1. What are some strategies and policies going forward? 2. What are some opportunities to partner with the community? 3. What are some of the barriers in the U.S. health system? 4. How does the health of a rural community compare to that of an urban center?
With so many unique health issues affecting different countries, it is impossible to have one single universal strategy toward approaching these problems. For example, illnesses such as malaria, tuberculosis, HIV, and other communicable diseases that affect low-income regions do not tend to distress developed countries with the same fervor. Similarly, obesity, cardiovascular disease, and cancer are predominantly illnesses of the western world and not as common throughout underdeveloped countries. Though many of these diseases are on the rise worldwide, it is important to develop regional strategies best suited for their specific needs. However, one thing is certain: all of these issues require more than just clinical healthcare. In order to move the United States from a disease-centered system toward a more preventative one, the entire culture of healthcare and related industries needs to be changed. With a majority of patients only seeking medical attention when they are ill, it is difficult to change their behavior to include more wellness checkups and more frequent communication with their doctors. In fact, one recent study demonstrated how frequent checkups with nurses – even through simple modes of communication like speaking over a
SESSION 3
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“The healthcare delivery system as it is currently constituted cannot fix all health. It needs to efficiently and effectively deliver healthcare services, but the concept of health has to be embedded in a much broader framework of our society – not just access to healthcare delivery but also access to clean water, clean air, healthy food, and exercise.” Alex Philp, Founder and CEO, Upstream Health
“Leveraging technology to overcome access has got to be a part of the plan.” Herman Williams, SVP and Chief Medical Officer, RegionalCare Hospital Partners
“Telemedicine is not to replace anything – it’s to adopt, complement, and help.” Nick Assad, Senior Vice President, Business Development, CirrusMD
OPPORTUNITIES phone – dramatically lessened disease outcomes. By communicating about their diet, exercise, and general health with a trained professional, people were able to prevent disease and alter their lifestyle to fit healthier alternatives. Another issue is the issue of money. With insurance companies primarily profit-centered and many physicians under monetary pressure to recommend certain products, it can be difficult for patients to accurately assess their health situation. Similarly, the past 50 years has seen the healthcare delivery system prioritize scarcity of healthcare providers over patients. With so many competing forces affecting health care providers, it would appear that the focus is rarely put on the patient. Lastly, the quality of health in a community can be measured by how far it is from an urban center. With large cities full of the best hospitals, technology, and talent, rural areas often lack the tools necessary to improve their healthcare system. With a lack of tertiary doctors available in rural hospitals, many patients often have to drive hours to receive specialized care. It would appear that our extremely expensive healthcare system has inadvertently put the patient’s needs last.
One strategy to alleviate the distance problem is through regional hospitals. Hospital company RegionalCare focuses on establishing regional hospitals outside major markets that would serve as feeders for critical access hospitals to provide the care that they can’t provide themselves. With an emphasis in secondary tertiary care, RegionalCare believes that their model is the most effective way to better serve rural populations with both general and specific health needs. Another strategy created to widen access to healthcare is through telemedicine. Through telemedicine, patients have unlimited access to a panel of medical professionals who can answer questions or help locate specific health care providers best suited to their needs. The system is local and value-based, and patients have several different communication options to choose from, with text messaging being the popular choice. This helps eliminate non-critical doctor visits as well as decrease health costs for patients. Through
telemedicine, healthcare access can be more widely spread while patients can receive more instant care. Rather than focusing on distance, the Care Coordination Model is focused on bringing healthcare teams together in an effort to reallocate responsibilities. With such a physician-centered healthcare system, it is important to include nurses, pharmacists, social workers, and other healthcare professionals in the decision making process. This would free up the physician to take care of more patients while also widening the amount of access a patient has to healthcare professionals. There are an unlimited amount of potential strategies to solve healthcare issues. Whether its focused on providing more access to the patient, altering the system itself, curing widespread disease or focusing more on prevention, we have finally reached an era where all health issues can be adequately addressed through unique strategies tailored specifically to that region. ■
“If we want to change the policy in this country – even the policy on a global level – we need to understand that innovation and research creates change.” Joxel Garcia, Executive Director, Cancer Prevention and Control Platform, University of Texas MD Anderson Cancer Center
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Session 4: Value Health: Delivering Value in Perinatal Care SESSION PANELISTS: PETER GRUBB, Medical Director, Tennessee Initiative for Perinatal Quality Care, Associate Professor of Pediatrics, Vanderbilt University Medical Center KELLY MCQUEEN, Director, Global Anesthesia Program, Fellow, Harvard Humanitarian Initiative BILL PAUL, Director, Metropolitan Nashville Health Department MODERATOR: REMY SZYKIER, Managing Partner, Aegis Health Security
SITUATION One of the biggest challenges facing the U.S. in the 21st century is its convoluted healthcare system. At $8000 per person per year, the United States spends more on healthcare than any other country in the world. Even more concerning, the majority of this healthcare money is spent on in-patient clinical treatment, with only a small percentage being used toward other health-related areas such as prevention and education. Despite its citizens’ hefty investment in healthcare, the U.S. is only ranked #27 in terms of life expectancy at birth. Perhaps even more concerning, the U.S. is ranked #13 in infant mortality rate. Though there are large disparities between states and cities, a number of low-income areas have infant mortality rates well below standard Organization for Economic Co-operation and Development (OECD) levels. For example, the city of Nashville has an infant mortality rate of 7.6 per 1000 births, a number that is roughly equal to infant mortality rates in Puerto Rico and Malaysia. Though Tennessee has access to some of the best healthcare systems in the country, they are ranked at a mere #45 in terms of health. There are many social, biological, and environmental factors that affect infant mortality rates as well. In fact, the
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World Health Organization—and even the Central Intelligence Agency—often uses this data to assess a community’s overall health due to large amount of factors that affect both infant mortality and other aspects of health. With such a strong correlation between infant mortality and a community’s overall health, it is imperative that perinatal care begins to receive the attention it needs to improve overall health in society.
KEY QUESTIONS 1. Where are the gaps in perinatal care? 2. How can perinatal care solutions used in urban settings be scaled up globally? 3. What can we do better in perinatal health? 4. What are the barriers preventing women from better perinatal care?
“Once you can address these behavioral health aspects and integrate that into the entire healthcare routine, making and shifting investment is powerful.” Remy Szykier, Managing Partner, Aegis Health Security
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Value Health: Delivering Value in Perinatal Care
“The big prescription [to perinatal care] may seem a little less medical and a little bit more ‘how do we design communities? What is our housing policy? What do we talk about in school when we’re talking about your life plan or your plan for reproduction?’” Bill Paul, Director, Metropolitan Nashville Health Department
CHALLENGES Although perinatal care is essential to ensuring the health of both mothers and infants, there are many areas in the U.S. where both maternal and infant mortality rates are equal to that of underdeveloped countries. This is due to the fact that perinatal care is constrained by socioeconomic factors, such as education, safe housing, employment, access to health care, and equity; therefore, communities with low-income populations often have the highest mortality rates among infants and mothers. Similarly, infant mortality rates are much higher among Non-Hispanic African Americans in comparison to Caucasian Americans. Surprisingly, the mortality rate between Non-Hispanic African Americans and Caucasian Americans decreases significantly when you measure infants in neonatal units. This demonstrates how disparities in mortality rates are primarily located in the realm of maternal health and care rather than infant care. For example, many pre-existing ailments that affect mothers vicariously affect an infant’s health as well, with diseases such as HIV and AIDS increasing both maternal and infant death rates. There are many other factors that affect maternal and infant mortality, such as distance from home to hospital and lack of education about perinatal care. Without
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proper education about healthcare procedures and surgery, many mothers in rural areas are hesitant to visit with healthcare professionals as there is often stigma surrounding surgery and medicine. One of the largest causes of infant mortality in the state of Tennessee is unsafe sleep practices. With nearly 25% of infant deaths caused by Sudden Infant Death Syndrome, there has been a recent push at both the state and local level to understand why such a large percentage of babies are dying from preventable causes. Studies conducted by the state of Tennessee found that infants often died in the care of a temporary caregiver, such as a babysitter or relative, due to their lack of knowledge on safe infant care practices. Programs have since been proposed to surround both mothers and alternate caregivers with more practical knowledge related to infant care. When looking at perinatal care from a global perspective, the associated problems most acutely manifest
themselves in low- and middle-income countries. Although maternal mortality rates have decreased from 500 thousand deaths per year to 250 thousand deaths per year since the adoption of the Millennium Development Goals (MDGs), many countries in Sub-Saharan Africa and Southeast Asia have not experienced the same trend. Similarly, infant mortality rates in these areas often exceed 500 deaths per 100 thousand live births, affecting both infant and maternal mortality rates. Some of the biggest contributing factors to maternal mortality rates are related to cervical health. When the Global Anesthesia Program conducted research to find the biggest causes of maternal mortality, they found that 5 out of the 7 main causes were related to cervical diseases and could be solved with cervixcentered solutions. With hemorrhaging and obstructed labor being the two largest barriers to a healthy delivery, it is imperative that access to surgery and
“The infant mortality and prematurity rate are a reflection of the health of a community – that includes the social capital, social fabric, and social supports and stressors.” Bill Paul, Director, Metropolitan Nashville Health Department
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UN Photo / Martine Perret
safe anesthesia be increased in these areas. Indeed, without the intervention necessary to solving problems during labor, 7 out of 8 women will die from obstructed labor or Eclampsia. In 2015, the Lancet Commission found that out of the world population of 7 billion, over two-thirds lack access to safe surgery and safe anesthesia. When looking at barriers to surgery, factors such as distance from hospitals, lack of trained medical professionals, and general fear of surgery were cited as the biggest factors. In terms of maternal health, these barriers can lead to serious consequences or even death. Lack of cervical services in basic health care, walking to a distant hospital while in labor, and being unable to undergo an emergency C-section all lead to a dramatic increase in both maternal and infant mortality rates. When C-section rates are less than 10%, mortality rates increase 400-1100 deaths per 100,000 live births. And with most high risk countries at a mere 1% when it comes to C-section rates, it is obvious that a drastic change needs to be made to increase access to surgeries worldwide.
OPPORTUNITIES With access to safe surgery and safe anesthesia a necessary component to improving maternal and infant health, the World Health Organization recently adopted emergency and essential surgical care – including safe anesthesia – as part of universal health coverage. Similarly, the Global Surgery 2030 report by the Lancet Commission states that surgery and cervical health should play a bigger role in discussions surrounding the SDGs. As discussion surrounding the topic of surgery, anesthesia, and cervical health increases, there is hope that global access will increase as well. One such organization that is already beginning to increase access to safe surgery and safe anesthesia is Vanderbilt University. Partnering with GE in Sub-Saharan Africa, these organizations focus on training nurses and practitioners on how to properly administer anesthesia. By training practitioners in only one specific sub-set of anesthesia - such as spinal-related anesthesia procedures - practitioners can master the skill quickly and provide frequent and high quality work. Similarly, practitioners can be trained specifically in how to perform C-sections or other forms of anesthesia.
On a smaller scale, community-based approaches to improving perinatal care are proving to be highly effective. One such example is the Fetal Infant Mortality Review, whose goal is to bring healthcare providers together to discuss treatment of mothers who have lost an infant. By discussing both individual and aggregate cases, providers can identify points of intervention for community action and also areas of disparity. The community can then provide support to the mothers through counseling, education, and healthcare services. Another way to improve perinatal care is through establishing support groups where communities are shattered. Usually, mothers-to-be learn skills from other women in the community; when communities are prone to violence and poverty, however, bonding experiences and practical education are not as accessible. In some areas, programs will create short videos explaining practical lessons in motherhood, such as breastfeeding, to supplement the lack of mother-based communities. In other programs, groups of women who are pregnant at similar times will be brought together in order to go through prenatal care together. This has been show to decrease pre-term births, as well as increase mother and child health through follow-up sessions. â–
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PROSPERITY
Session 1: Ending Poverty in All Forms Everywhere: Regional Economic Solutions (SDG1) SESSION PANELISTS: MATT ERSKINE, Deputy Assistant Secretary of Commerce for Economic Development & COO, U.S. Department of Commerce JAN RIVKIN, Bruce V. Rauner Professor of Business Administration, Harvard Business School, U.S. Competitiveness Project LOREN RODGERS, Executive Director, National Center for Employee Ownership BISHOP WILLIAM SWING, President and Founding Trustee, United Religions Initiative (URI) MODERATOR: MUKHISA KITUYI, Secretary-General, United Nations Conference on Trade and Development (UNCTAD)
SITUATION With the recent adoption of the Sustainable Development Goals (SDGs) by the United Nations (UN), countries from around the globe are beginning to propose a broad range of potential solutions to ending global poverty. With the first SDG aimed toward the complete eradication of poverty in all forms everywhere, businesses, academic institutions, governments and even citizens need to work together in order to eliminate global poverty and spread prosperity. There is one country who is already well on their way to achieving this goal. Between 1994 and 2014, China grew their GDP 7.5% per capita and reduced extreme poverty from 46% to 11.8%. By investing in economic infrastructure and creating sustainable livelihood, China was able to transition from being one of the least developed nations in the world into becoming an economic powerhouse. Similarly, the goals outlined in Agenda 2030 not only plan to reduce extreme
poverty, but completely eradicate it. With nearly 50 countries around the globe sustaining an extreme poverty level similar to that of China’s in the 1990’s, it is crucial that developed nations work with these countries in an effort to raise their standard of living. Although China’s rapid rise to power was accompanied by devastating environmental repercussions, the Sustainable Development Goals aim to end poverty in these developing nations with as little a carbon footprint as possible. In order to do this, Mukhisa Kituyi argues that we need to invest policy, resources, and purposefulness into economic enablers that can help us achieve this ambitious goal. Creating the means without purposeful focus on social goals will not necessarily deliver on the social good, he stated at a recent panel. Therefore, it is important that we find coherence between means of implementation and the social goals to be achieved.
KEY QUESTIONS 1. How can we work together to end poverty everywhere? 2. What are some policies and initiatives that have been developed to expand economic prosperity and growth? Which ones will have the greatest impact? 3. What is shared prosperity? What is inclusive growth? How can they be achieved? 4. How can employee ownership end poverty and enhance prosperity? 5. What are the symmetries between religion and prosperity?
“Imagine the pie of all the economic products in the world. Eliminating poverty is making sure the smallest slices of that pie get larger over time. Creating prosperity is growing the pie. And creating shared prosperity is making sure that as the pie grows, each of the slices gets larger.” Jan Rivkin, Bruce V. Rauner Professor of Business Administration, Harvard Business School, U.S. Competitiveness Project
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Ending Poverty in All Forms Everywhere: Regional Economic Solutions (SDG1)
“Perhaps the global economy is not a game that should be played by the 1% using the 99% as chess pieces; perhaps we need capitalism with more capitalists – an inclusive capitalism in which fewer people are chess pieces and more people are chess players.” Loren Rodgers, Executive Director, National Center for Employee Ownership
“There will never be peace among nations without peace among religions, and there will never be peace among religions until someone creates a level playing field where we can deal with each other on a regular, daily, enduring basis.” Bishop William Swing, President & Founding Trustee, United Religions Initiative
“Creating the means without purposeful focus on social goals will not necessarily deliver on the social good.” Mukhisa Kituyi, Secretary-General, United Nations Conference on Trade and Development
CHALLENGES Although poverty levels in developing countries have been decreasing steadily in recent years, the global wealth gap has begun to increase at an alarming rate. With the top 85 richest people owning as much wealth as the lower half of the population, there is an unimaginably large wealth discrepancy between classes. Perhaps more surprisingly, developed countries are experiencing not only stagnation in their middle classes, but also an increase in poverty levels. According to Jan Rivkin, part of the problem stems from lack of shared prosperity. In the US, businesses have been systematically underinvesting in the commons for years. With little money flowing into training skilled labor, building strong infrastructure, and boosting research and development, the U.S. labor force is in a precarious state. Similarly, certain U.S. business practices have ended up working against worker bargaining power, leading to a population of disenfranchised employees. In addition to underinvesting in its own people, the U.S. also has to deal with the effects of technology-enhanced globalization. In the era of global markets, U.S. businesses not only compete amongst 74
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themselves, but with powerful foreign markets as well. The trend toward global rather than nationally-based companies has also led to an increase in outsourcing jobs in an effort to acquire cheap labor. Rather than alleviating economicallydisadvantaged regions, however, this sort of distant ownership gives companies the power to shut down factories whenever they need and move to regions with cheaper labor. With capital concentrating solely at the top levels of most businesses, employees are given little say in the matters of the company – including whether or not their town’s factory will stay open. The concept of shared prosperity would enable company employees to not only have more say in company matters, but also gain more wealth from the company and reinvest that money back into their local economy. If a factory is locally-owned by hundreds of employees rather than one CEO, it is more likely to stay permanently in that location. In order for a community to thrive economically, Matt Erskine argued, there are several aspects that need to be identified and put into practice. These are:
upport for transformative economic S initiatives and projects that are regionally developed. ■ Technical and financial assistance with improved hard and soft infrastructure. ■ Assistance in addressing expertise and resource gaps. ■ Improved policy on all levels of government. ■
Similarly, leveraging state and local development funds, university assets, and private capital in addition to facilitating the reorientation of local economies toward productive investments in the ecosystem is crucial to creating a prosperous community. One way to do this is through systematically reinvesting in the commons. This can be done through collaborations between business, education, non-profit, faith, labor unions and the likes, creating new partnerships such as civic alliances to rebuild infrastructure, or businesses partnering with academic institutions to train future employees. By injecting the necessary amount of capital into public goods, middle class America can reinvent itself and become a more productive and prosperous workforce.
SESSION 1
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OPPORTUNITIES The U.S. Department of State is constantly trying to expand shared prosperity in America and around the globe. Some of the ways in which they’re nurturing growth is: ■ Growing trade and investment ■ Supporting innovation ■ Unleashing the power of data ■ Investing in people through skills
training programs More importantly, the Department of State emphasizes the need to focus on economically stressed communities in the U.S. in order to help them become more resilient as well as gain the skills necessary to become full participants in the global economy. Matt Erskine argues that this can be done in two different ways: 1. By focusing on high growth and regionally competitive areas of innovation. By expanding the capacity of individuals, businesses, and communities, skills and talents can be maximized. This can be done through supporting innovation, lowering transaction costs, and responsibly trading goods and services. Reducing
private investment risks and improving the business environment can also make communities more attractive to job growth. 2. By implementing a place-based, bottom-up approach. By investing in local organizations and using local resources, companies can be sure that their employees will have the skills and knowledge necessary to succeed in their unique communities. Another way to grow shared prosperity is through inclusive capitalism. In the 10,000 employee-owned companies in the U.S., employee owners reportedly earn 2.5 times more than regular employees. These companies tend to be 4-5% more productive than their competitors, lay employees off at a quarter of the rate of normal companies, and create more jobs than traditional businesses. By tying their wages to asset building, both employees and their company have the potential for tremendous growth as well as increased benefits. Creating employee ownership can also be accomplished through micro-financing. Microfinance gives people who do not usually have access to capital the power
to start a business. Loren Rodgers argues that if several people were to combine their finances and create an employeeowned company, they could accomplish more as a group than as separate individuals. Micro-financing can also be used on pre-existing businesses to expand the amount of employee owners. In order to end poverty, spread prosperity and stimulate inclusive capitalism, cooperation is key to achieving these goals. In an effort to promote peace and cooperation, Bishop William Swing suggests creating cooperation circles to bring people of different backgrounds together. Since its inception, over 700,000 cooperation circles have been created, with at least seven people from three traditions working together in each circle. Completely self-governed and self-funded, these circles aim to promote solidarity between different religions, cultures, classes, and sectors. By understanding each other’s differences and using these to their advantage, businesses, governments, and even societies can achieve the goals outlined in Agenda 2030. Only through cooperation can every country work together to spread prosperity and eradicate poverty once and for all. ■ SEPTEMBER 2016
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Session 2: Shared Value and Global Economic Inequality SESSION PANELISTS: TOM BAKKUM, Innovation Lead, Climate-KIC, European Union DANIELLE CORLEY, Researcher, Center for American Progress SHIRA KILCOYNE, Director of Government Affairs, GSK TODD LEMONS, Founder, InfiniteEarth MODERATOR: JUSTIN BAKULE, Executive Director, Shared Value Institute
SITUATION
KEY QUESTIONS
With the adoption of the United Nations’ Sustainable Development Goals (SDGs), the issue of global inequality has risen to the forefront of international debate. Under SDG1, whose goal is to end poverty in all forms everywhere, many solutions have been proposed in an effort to solve this pressing issue. One of the most prevalent solutions is the shared values initiative. Companies and NGOs who practice shared values view social issues as opportunities for growth and innovation, integrating new business models centered on solving the specific social issues that intersect with their business. With SDG1 focused on driving prosperity to the bottom half of the wealth pyramid, companies involved in health, environment, education, and similar industries have the option of participating in the shared values initiative in order to provide necessary goods – such as access to medicine and quality education – to those at the bottom. By focusing on social issues, these businesses have the unique opportunity to not only spread prosperity, but turn a profit on it as well. It is imperative that companies become more socially and environmentally responsible, because without society or the environment, companies cease to exist.
1. How do you balance tradeoffs between communities, the environment, and social needs in a way that works for big business? 2. Although investors are beginning to recognize risk, are they recognizing opportunity-based companies as well? 3. How far along are we in perfecting business-driven approaches to alleviating poverty and inequality? 4. What are some things that will accelerate shared value solutions? 5. What regulations impede the implementation of these longterm agendas?
CHALLENGES One of the biggest challenges faced by companies participating in the shared values initiative is finding investors who support their cause. With most shareholders vying for somewhat quick returns on investments, it can be difficult for companies to find investors who are willing to invest in longterm projects. Similarly, the risks involved in investing in social issues and the lack of a guaranteed return often deter shareholders from committing to these projects. Though
there is a community of investors looking for socially responsible companies, the majority of shareholders tend to focus on the risks involved rather than taking an opportunity-based approached, thereby ignoring the growth potential of these companies and limiting their progress. In order to bring more investors into these companies, the curriculum in business schools needs to be reimagined in a way that highlights the benefits of socially responsible companies. Next, companies who invest in social issues need to innovate in ways that provide both business-driven growth and real solutions to social problems. Lastly, as society becomes more aware of these business-driven solutions, risk managers will need to take into account new socially driven dimensions to investing in companies. With millennials set to take over the economy in the coming years, it is imperative that these changes be implemented as soon as possible in order to fit the views and lifestyle of this new generation. As important as it is for investors and businesses to promote social change, it is essential that society itself acts in a way that will also embrace these changes. According to Todd Lemons, companies generally act in their own best interest. ➥
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Shared Value and Global Economic Inequality
“At Rimba Raya, we don’t build fences – we build communities. We do this by delivering health care, access to clean water, and by investing in community enterprises. By doing so, we aim to change the dynamic that has historically existed between these forest-dependent communities and the forest.” Tom Bakkum, Innovation Lead, Climate-KIC, European Union
“Changing the DNA of companies to include social issues in how the business is planned, realized, and delivered is a fundamental shift in how business education is taught. It’s a shift in how managers work as well, and often requires skills that are far more advanced than just being able to read a PNL.” Justin Bakule, Executive Director, Shared Value Institute
➥ Therefore, it is up to society, not businesses, to change the current economic model in order to bring about social change. For example, an alarming amount of bio-diverse tropical forests are burned down in Indonesia each year in an effort to create more palm oil plantations. These factories then go on to produce junk food, an extremely in-demand global product that ends up incentivizing deforestation. Todd Lemons argues that it is not the palm oil plantations that created this business model, but society and its promotion of junk food. Solving social and environmental problems – such as deforestation – is a shared responsibility between the consumer, the manufacturer, and the government. Therefore, it is up to society to create incentives that both serve the company’s interest as well as the greater good. There are many practical barriers to implementing these social goals as well. For example, though the employment of electric buses is necessary to lessening gas emissions, integrating a new mode of transportation would necessitate a complete overhaul of the current system. Similarly, many countries lack the right regulatory infrastructure to register medicine in a timely manner, making it difficult to provide vaccines to communities who need them immediately. Revamping the current infrastructure of these systems would not only require a lot of money, but time as well. Although there is a growing interest in companies assuming more social and environmental responsibility, there is 78
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still a lot of work to be done. Companies need to look at social and environmental responsibility in new ways where social issues are not separate from the rest of the business, but completely integrated into the business model. Luckily, many companies are beginning to adopt this model; however, there is a long ways to go before any real impact is made.
■ RESEARCH
– R&D needs to be conducted within Africa and Asia in order to pinpoint diseases and health issues specific to that region.
■ MANUFACTURE AND
SUPPLY – By manufacturing on the Asian and African continents, the cost of medicine can be reduced while also being made more accessible and simultaneously eliminating supply chain problems.
OPPORTUNITIES
■ CAPABILITY AND
One such company that is involved in the shared values initiative is GSK. Although the pharmaceuticals company is based in the UK, one of their biggest goals is reaching 80% of people in the developing countries of Africa and Asia by 2020 and providing them with the unique medicines needed for each area. In order to achieve this, Shira Kilcoyne argues that businesses must partner with NGOs, academics, and other sectors in order to be successful. GSK’s approach to solving these health issues is based on five pillars:
SKILL STRENGTHENING – Training local talent to work for GSK can lower costs and provide jobs for the community.
■ AFFORDABLE AND ACCESSIBLE
MEDICINE – The price of the product will never be more than 25% of the cost of products in the UK. ■ A
20% REINVESTMENT – GSK commits to reinvesting 20% of the company’s product into the countries’ infrastructure by creating programs geared toward training health care workers.
““I think what you see between the sectors are tectonic plates shifting – the roles that the private sector can take, how NGOs partner with them, and what governments and regulatory bodies can do in response. Tectonic plates, by definition, are slow moving, so that’s what you see.” Justin Bakule, Executive Director, Shared Value Institute
SESSION 2
Another organization that is involved in the shared values initiative is InfiniteEarth, an environmental mitigation banking business dedicated to the upkeep of a biodiversity reserve in Rimba Raya, Indonesia. This reserve houses one of the last remaining high-density populations of wild orangutan in the world, as well as a privately-funded wetlands reserve that is certified to have avoided 130 million tons of greenhouse gas emissions. Not only are they committed to the protection of the forest’s environment, but the wellbeing of the community surrounding the forest as well. InfiniteEarth’s unique business model is based on the selling of environmental mitigation credits to corporations in the developed world. By delivering environmental offsets to corporations around the world, it enables them to become custodians of the forest and economically productive biological reserve. Another such organization is the European Union’s Climate-KIC initiative, which is focused on three areas:
PROSPERITY
■ SUSTAINABLE
URBAN DEVELOPMENT – The world population is increasingly living in cities, and, by 2090, 85% of the population will be urban. Therefore, sustainable urban development is crucial.
■ SUSTAINABLE
PRODUCTION – Reduce, reuse, and recycle.
■ SUSTAINABLE
LAND USE – Agriculture, especially in the developing world, needs to be made more sustainable through public-private partnership.
Lastly, the American Worker Project by the Center for American Progress focuses on shared value by looking at the economy from a worker’s perspective. By conducting research to increase wages, benefits, securities, and rights, the project found that inclusive capitalism is beneficial to both the employer and employee in spreading prosperity and reducing poverty. Workers benefit by receiving higher pay, better
benefits, greater job security, participation in company decisions and better labormanagement relations while businesses benefit from increased productivity, profitability, and greater likelihood of company survival. Lastly, the study found that inclusive capitalism has the potential to increase wealth of low-wage workers and decrease income disparity between classes. There are several factors that are needed in order to accelerate the shared values initiative. First, consumers and investors need to reward companies for good, socially responsible behavior. Second, the combined national ambitions for greater social responsibility will be necessary to create peer pressure between countries to compete amongst each other in an effort to become the most socially responsible. And third, there needs to be financial incentives not only from consumers, but government policies as well. ■
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Session 3: Training Leaders for Shared Prosperity: Developing Future Regional Economic Leaders SESSION PANELISTS: PENNY JUDD, President, PennAvenue Strategies SHAKA MITCHELL, Regional Director (TN), Rocketship Education MELISSA WADDEY, Senior Vice President, Operations Strategy and Integration, Lifepoint Health MARCUS WHITNEY, President, Jumpstart Foundry MODERATOR: MANJARI RAMAN, Program Director and Senior Researcher, U.S. Competitiveness Project, Harvard Business School
SITUATION In an effort to understand the issue of competitiveness in the United States more clearly, the U.S. Competitiveness Project was developed by Harvard Business School. Beginning in 2013, the project was created in order to assess the state of the U.S. economy and its competitiveness. The following questions were asked in a survey conducted by the business school: What is wrong with the U.S. economy? At the time of the survey, the U.S. was coming out of a dark recession. This was attributed to several deep structural issues within the economy becoming continually more solidified over several decades. Some of these issues included overspending, a growing deficit, and a widening class gap. The biggest issue lay in the divergent nature of the U.S. economy. At the individual level, highly skilled entrepreneurs with a college background were able to achieve success with relative ease whereas low-income individuals without the means for a college education were often unable to reach the same levels of success as their educated peers. Lack of access to quality education, good jobs, and solid support systems often barred lowincome individuals from learning the skills necessary to survive in this new economy. In terms of business, large global firms based in the U.S. often reaped the benefits
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of the U.S. economy while avoiding its inherent problems. Small businesses, on the other hand, could not move and were therefore subject to convoluted tax codes, health care costs, a poor education system, and lack of skilled labor. This divergent behavior has created an economy where global companies, highly skilled individuals and tech startups thrive while low-class workers struggle to fit into the work system’s framework. With an increasingly divided workforce, the American Dream is in danger of becoming extinct while U.S. competitiveness continues to lose its edge. What is competitiveness? Competitiveness is the ability of firms to successfully operate in a specific location and compete globally, all while ensuring that the citizens of their community have access to living wages, rising standards of living, and the ability to aspire for a better life. Companies who are successful financially but lack the ability to improve their community cannot be considered competitive, and vice versa. While this form of business is common, it is unsustainable and therefore not competitive enough to succeed in the long run. When surveyed about U.S. competitiveness and how the U.S. economy compares to other developed countries, HBS alumni noted that the
United States is strong in terms of entrepreneurship, firm management, the university system, property rights, capital markets, and innovation. However, problems with labor, macro policy, regulation, and the deficit often hold the U.S. from becoming more competitive, while major problems with the K12 education system, tax code, political gridlock and health care negatively affect competitiveness both internally and externally. How can research gathered from the U.S. Competitiveness Project be used to improve the economy? After conducting their research, Harvard Business School used its findings to create the Young American Leaders Program. After gathering 90 young leaders from nine cities across the U.S. the members of the program were then put through a week-long boot camp on competitiveness in an effort to promote shared solutions and shared prosperity. With leaders from sectors across the board – including education, big and small business, government, and media – working together to transform both their cities and the U.S. economy as a whole, the concept of shared prosperity is beginning to spread throughout the U.S. However, there is still a long way to go. ➥
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Training Leaders for Shared Prosperity: Developing Future Regional Economic Leaders
“In the next decade it’s really going to be about having people from really diverse backgrounds – with diverse ways of thinking and approaching policy problems – come together, give up some of their old ways, adopt and adapt to each other’s ways, and find solutions to really difficult problems by working together.” Manjari Raman, Program Director and Senior Researcher, U.S. Competitiveness Project, Harvard Business School
“We need to be teaching people how to create 21st century small businesses that can actually survive in the new economy, and try to direct them to solutions that can thrive in collaboration with existing corporations.” Marcus Whitney, President, Jumpstart Foundry
KEY QUESTIONS 1. Does the challenge of shared prosperity constrict a business’s main goals? 2. Why are cross-sector collaborations so important? 3. How will the roles and structure of government be different in the future? How will partnering with business be different for government policy makers? 4. What problems do small businesses face in today’s economy? 5. How does shared prosperity work in different markets? 6. Ultimately, what should happen and what is the timeframe it should happen in?
CHALLENGES “As we become more globally connected, we are less connected to our neighbors,” said Shaka Mitchell. In the age of the Internet, it is easier to pull up Yelp for restaurant suggestions than ask a friend for ideas. Instead of asking questions to professionals or knowledgeable acquaintances, most people turn to Google as their first resource. However,
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programs like the Young American Leaders Program attempt to reconnect people on a personal level through intensive weeklong boot camps. Manjari Raman believes that the synergy created by people sitting at a table together and brainstorming solutions is much more effective than anything the Internet could provide. Although connectivity on a global scale is important, connecting at the local level is just as significant. According to Penny Judd, every government, business, and individual has a role to play in shared prosperity. At the individual level, people
are connected to the economic vitality of their community. Similarly, businesses depend on the individuals and the community in which they are located. Finally, it is up to government to act as a catalyst for shared prosperity by partnering with both big and small businesses and promoting individual well-being. For example, the market for STEM jobs in Tennessee is higher than the national average, so it is important for the state and local governments to create talent pipelines in an effort to fill the STEM skills gap. One such way they have tackled this problem is through a partnership between government and business. After receiving federal stimulus funding in 2011, the Tennessee government partnered with local businesses in order to establish 6 STEM schools across the state. After its initial success, similar efforts have been made to establish more schools and certification programs throughout Tennessee. Another challenge comes from small business. In the age of digital markets, it can be difficult to start a mom-and-pop type business with a physical location. With Internet business booming, demand for local goods has lessened and 20th
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century businesses often have a difficult time transitioning into the 21st century technology-centered framework. Similarly, physical businesses have to deal with expensive real estate, health care, tax codes, and costly insurance that Internet businesses do not have to deal with. The last challenge comes from cross-sector collaboration. As different communities interact and begin working together on shared prosperity, it is important for all sectors to communicate in order to avoid having their efforts reproduced. As Penny Judd puts it, “we need to look at the vitals and data to help create a shared mental model across sectors so we’re not duplicating efforts and instead moving toward the same goal.”
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OPPORTUNITIES There are a multitude of businesses beginning to work toward solving social issues and promoting shared prosperity. For example, Lifepoint Health not only focuses on providing both in-patient care and preventative services to communities, but also promotes job growth as well. According to Melissa Waddey, every time a physician is recruited to a hospital, 10 additional jobs are created in a community. This creates shared prosperity and strengthens the community and hospital staff. Another way to promote social enterprises is through networking. By leveraging networks and connecting
NGOs, private businesses, investors, and the government, visibility around social issues increases and shared prosperity becomes more viable. Similarly, shared prosperity promotes empathy, diversity, and leadership through strengthened connectivity between sectors and collaboration on social issues. Ultimately, shared prosperity will lead to stronger alignment among leaders, empathy toward different sectors and communities, stronger business leadership involvement, a deeper understanding of diversity, and more connectivity between leadership groups. ■
“It’s not just giving money, and it’s not just volunteering and giving time – we have to be much more intentional about what we’re doing in our communities around creating shared prosperity outside of normal business.” Melissa Waddey, Senior Vice President, Operations Strategy and Integration, Lifepoint Health
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Session 4: The Future of Impact Investing SESSION PANELISTS: CRAIG HERYFORD, Shareholder, Buchanan Ingersoll and Rooney JIM SCHORR, CEO, Social Enterprise Alliance MICHAEL SHMERLING, Chairman, XMi Holdings, Inc. WOODY TASCH, Founder, Slow Money MODERATOR: REMY SZYKIER, Managing Partner, Aegis Health Security
SITUATION Throughout most of the 20th century, businesses were funded through investment opportunities focused on yielding the lowest possible risk for the highest possible return. With the introduction of a new millennium, however, focus has shifted from a purely monetary standpoint to solving big social problems. The rise of the social enterprise has created a need for new, more diverse forms of investing that focus on social responsibility in addition to returns. Although social responsibility has been present in organizations since the dawn of religion, the concept of impact investing has existed for less than a decade. Dedicated to creating change, impact investing focuses on modest risk and modest returns in an effort to create as much social impact with as little loss as possible. Rather than focusing on investments from a purely business perspective, impact investing integrates social intent with a market-driven approach. Despite its good name, many still question the usefulness – or even the uses – of impact investing. With its relative newness and ambiguity, this new form of investing offers a plethora of potential avenues and opportunities – but at what cost?
KEY QUESTIONS 1. What are the main fears of impact investing? 2. Why is impact investing on the rise? 3. How can an investor make a return on an investment based in social causes? 4. Is impact investing a lasting trend or just a flash in history?
CHALLENGES One of the biggest fears associated with impact investing is the potential risk of loss. For example, 25 years ago the Ford Foundation began putting aside assets to be used toward social causes in order to reaffirm their footing as a foundation with strong social responsibility. In an effort to lessen the blow to their assets, the foundation anticipated a loss of at least 15% in their social funds and calculated the rest of their budget to absorb the loss. Similarly, in the UK, several social innovation funds pooled together their assets in an effort to increase spending
power but soon came to a not-sosurprising conclusion. Over the span of several years, the budget revealed that the pool of funds was actually operating at loss, with only 91 cents returned for every dollar invested. This raises several questions: does impact investing inherently operate at a loss? And if so, should that dissuade businesses from using it? If impact investing becomes characterized exclusively around its ability to reach market or near-market returns, it will eventually fail. Though the fear surrounding impact investing is highly exaggerated, it is not completely unfounded. Ultimately, thousands of social enterprises do not and will not make market returns; however, it is still critical – perhaps even more so than with regular businesses – for social enterprises to receive investment. Like all other types of investing, the success of impact investing depends on the situation it is used in. One example of successful impact investing comes from the t-shirt manufacturing company Threads. Originally started as a business that used alternative methods to drastically cut down on water usage, ➥
“Investing in impact – such as social welfare and socialgood projects – is good for business. Plain and simple.” Michael Shmerling, Chairman, XMi Holdings, Inc.
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The Future of Impact Investing
“We are looking at how to come together, de-risk investments, and really look at how we’re measuring impact so that from a policy and regulatory perspective, we can bridge the civic role of government to market-driven initiatives.” Remy Szykier, Managing Partner, Aegis Health Security
“If someone has a great, socially-responsible idea but doesn’t have a good business plan and cannot run it as a real business, it just doesn’t work.” Craig Heryford, Shareholder, Buchanan Ingersoll and Rooney
“People want to see the products they buy, the companies they invest in and the things they do be a bit more socially responsible.” Woody Tasch, Founder, Slow Money
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Threads increased their social responsibility by creating a manufacturing plant in Haiti, hiring a local workforce and using plastic bottles as an alternative fabric. They then went to vendors who highlighted eco-friendly brands, such as Timbaland and NorthFace, to sell their brand. With the help of investors, Threads was able to launch their line and receive huge returns. Without their eco-centered business model, Threads would not have been able to sell or create returns for their investors. Oftentimes, one of the biggest factors that lead to social enterprises failing is their lack of business-centered agendas. With high regards to social responsibility, enterprises often lack the essential business skills required to operate successfully. One method to solving this problem is through hiring a seasoned business professional to help create a solid business plan at the time of startup. Though it may be costly in the beginning, creating a businessminded backbone for a socially responsible company pays off in the end. Ultimately, impact investing is not just about returns – it’s also about scale. With so many large-scale social problems that require even bigger solutions, it is critical that these social enterprises receive the funds necessary to create change and solve mankind’s biggest problems.
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OPPORTUNITIES Impact investing is the way of the future. Surveys conducted by Deloitte show that 77% of millennials rank ‘purpose of an organization’ high on their priority list when searching for a job. Similarly, Morgan Stanley found that millennials are twice as likely to invest in a company if that company has a social purpose. With the new generation putting such a strong emphasis on social solutions, it is vital for businesses to begin investing more in social causes. Though many fear that impact investing costs more than it is worth, there are several promising enterprises where impact investing could create both social impact and high returns. One such company is USBiology, whose research on Lyme disease contains promising findings that could potentially lead to a cure. By creating a solution to a unique problem in a fairly stagnant market, USBiology is able to both create social change while generating great returns for investors. It is this sort of business-driven approach to social ailments that helps investors become socially responsible while also generating enough revenue to continue investing in other causes. Another benefit to impact investing is the lack of competition in the social
innovation market. Unlike most markets, social enterprises tend to have less competition and require more collaboration between industry partners in order to succeed. Therefore, impact investing is a great tool to be used in building alliances, learning about new companies, and spreading the word about the social causes they are invested in. The last benefit to investing in social enterprises comes from their NGO-like strategies. Since these companies behave similarly to NGOs, they often attract money from philanthropists, foundations, and grants that do not require a rate of return. When blended together with investments, these funds can help boost the company as well as generate enough profit to guarantee a large return to investors. By investing in a socially responsible company, you help create lasting solutions to problems that have plagued mankind for decades. You create important and meaningful connections with people who are also trying to change the world. Most of all, you help advance the world into an age where problem solving is the norm, not the exception. ■
SESSION 5
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Session 5: Finding, Tracking and Scaling Solutions to Achieve the SDGs SESSION PANELISTS: PUNEET AHIRA, Systems Architect and Special Advisor to the U.S. Chief Technology Officer, The White House KEVIN HARMON, Founder and CEO, Brisa International PAT WALSH, Co-Founder, Chief Impact Officer, Classy MODERATOR: JAY CORLESS, Senior Director for Innovation, UN Foundation
SITUATION During the age of the Millennium Development Goals (MDGs), technologies such as the Internet, mobile devices, and big data were new and largely untapped. However, the past 15 years has seen unimaginable advances in technology, with technology now serving as the vertebrae for virtually every aspect of life. This unprecedented advancement has led to countless new inventions, pastimes, and even realities, and has created a barrage of new solutions to old problems. Though the MDGs saw intermediate progress, technology has created a renewed surge of hope for solving some of humanity’s biggest problems. With the UN’s recent adoption of the Sustainable Development Goals (SDGs), many are turning to technology to tackle these age-old problems. By combining technology with the entrepreneurship and ingenuity of up and coming generations, it may finally be possible to find lasting solutions to ending poverty, hunger, and even illness. Social entrepreneurs, disruptors, and innovators alike are coming together to change the industry, and new methodologies are being created daily. Already, a shift is being felt in the market as social issues begin to take center stage in business.
KEY QUESTIONS We are now entering an era of social innovation and global problem solving. According to Jay Corless, social innovation is the creation of an economically viable offering that delivers social impact. There are two components to social innovation: first, it must be economically viable; and second, it must deliver social impact. Though it was initially created over 15 years ago, it was not until recently that social innovation began to permeate the business sector as a whole. With many businesses focusing on social responsibility, entrepreneurs are beginning to work toward creating projects that both solve social problems and receive returns. With social responsibility, technology, and entrepreneurship beginning to take the industry by storm, there is growing hope that lasting solutions to age-old problems will finally be found in order to achieve the SDGs.
1. What are some of the opportunities that lie ahead for social entrepreneurship? 2. W hat is Google X? How are they involved in scaling solutions? 3. W hat is a moonshot? 4. W hy are networks important to moving solutions forward? 5. W hy is transparency so important?
“It’s so easy to get caught up in the what and forget about the who. It’s the people who decide to spend the time, grit and energy to actually cause change that enable the type of transformation we want to see.” Puneet Ahira, Systems Architect and Special Advisor to the U.S. Chief Technology Officer, The White House
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Finding, Tracking and Scaling Solutions to Achieve the SDGs
“If we do something that solves a problem on the scale of millions of billions of people, the money will follow. So if we can think radically about that big change, we can shift our frames of reference in terms of what’s possible. That then allows us to leapfrog and create new industries and economies that didn’t exist in the past.” Puneet Ahira, Systems Architect and Special Advisor to the U.S. Chief Technology Officer, The White House
“We can solve big problems in ways we’ve never before imagined – with the right tools, insights and networks, we can achieve the global goals.” Jay Corless, Senior Director for Innovation, UN Foundation
CHALLENGES One of the biggest challenges to finding, tracking, and scaling solutions is the lack of connectivity between sectors and businesses in today’s market. Though there are new innovations being created daily, many of these companies lack the tools necessary to finding and collaborating with partners who can mutually benefit from solving social issues together. Indeed, a surprising amount of social enterprises aren’t even aware of similar projects being conducted worldwide, with duplicate efforts occurring frequently. Only by working together can social entrepreneurs scale up their solutions to take on the big problems.
Part of this problem is due to a lack of transparency. With social innovation still relatively new, there is no set standard or model with which innovators can operate on a large, industry-sized scale, nor is there an open source over which information to be freely passed. Industries such as finance, software, and medical science owe many of their advances to the transparency that is prevalent throughout their ecosystems. Unfortunately, this level of transparency has never really existed in a social space, making it difficult for social innovators to work in a global network. This has resulted in ineffective allocations of funding, duplication, and redundancy.
Similarly, many solutions to social problems are often limited to specific geographical areas with unique situations. For example, renewable energy company Brisa International recently created a new water purifying system tailored to the needs of the Middle East. In order to take the system international, they needed to collaborate with a number of companies from different sectors – such as manufacturing, technology, and environmental companies – to create a system that could work in any country. By working with a large array of companies to create a universal system, Brisa was able to scale up their solution
“We’ve got to think [about new technology systems] in an integrative sense. How does this integrate with other needs? Is there waste from one product that can be used in another system? It’s exciting because we’re seeing that these sorts of things can be done and there are tangible solutions that not only make environmental sense, but economic sense as well.” Kevin Harmon, Founder and CEO, Brisa International
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big enough to tackle the widespread problem of unusable water. Ultimately, there is a pressing need for radical innovation and sustainable business models. Social innovators need to create a structured community where businesses can remain secure, profitable, and sustainable all while incorporating open source elements in an effort to promote transparency and flexibility. Only when this happens can social enterprises successfully scale up their solutions.
OPPORTUNITIES Although the social innovation industry still lacks a solid structure under which collaboration can flourish, there are several companies who have begun to work toward establishing a worldwide network of social innovators. Google X, a research and development facility created by Google, recently launched their Solve For X project in an effort to highlight promising new ventures from around the world. Solve For X focuses mainly on moonshots, which are defined as
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audacious projects that focus on solving near-impossible problems. In order to be considered a moonshot, the project must consist of three components: a clearly defined problem, a new and radical way of thinking about the issue, and breakthrough science and/or technology that could potentially solve the issue. One successful example is Transatomic Power. Centered on the concept of clean nuclear energy, Transatomic Power recently set out to change the negative perception surrounding nuclear energy by creating a molten salt reactor that generates clean, safe, low-cost energy. With over 270 thousand metric tons of nuclear waste buried around the world – with enough energy to power the world for 72 years – Transatomic Power created a system that could put the buried nuclear waste to use in clean and efficient ways. Ultimately, Google X was able to accelerate the project and help build a community around the company in an effort to promote transparency and collaboration. Another company who is working toward more widespread collaboration is the aforementioned Brisa International. With the unveiling of their Ecotech water
purification system during the Global Action Platform, Brisa International was able to successfully showcase a scaled solution that was the result of worldwide collaboration, transparency, and the use of new technology. With the Ecotech system, communities can now turn pollution in the air, water, and land into low-cost energy while providing drinking water, high-quality fuels, and treated wastewater to neighborhoods with great efficiency. By combining multiple technologies, such as power plant systems, waste-toenergy technology, and biofuel algae systems, Ecotech is able to treat several water and waste problems at once. And by collaborating with a number of companies from around the world, Brisa International is also able to make Ecotech fully scalable as well as integrate-able with existing systems. Ultimately, the new emphasis on doing and thinking differently is shaping the future of society. With social innovation, connectivity, transparency, and technology being used to solve small problems, it is only a matter of time until these solutions can be scaled up to resolve the big issues of the SDGs. ■
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ABOUT THE GLOBAL ACTION PLATFORM
GLOBAL ACTION PLATFORM
Thought Leadership in Action Our Global Challenge BY SCOTT T. MASSEY
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ccording to the most recent estimates, the world’s population will grow to an anticipated 9-10 billion people by 2050. At the same time, the world’s population is migrating into cities, with current estimates projecting 60% of the population living in urban areas. The intersection of these two trends will result the highest percentage of human beings living in cities in human history. To put this growth in perspective, it is estimated that to provide the necessary built environment for this new urban population will require the equivalent of building a new city for one million people from the ground up every week for the next thirty-five years. The scale and speed of this projected growth will put enormous pressure on both cities and rural areas. Leaders must work energetically to prepare for this tsunami of change. To prepare, the world needs new, scalable urban and rural models that can accommodate the projected population shifts, and to leverage the change to usher in a new era of sustainable abundance.
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GLOBAL ACTION PLATFORM Global Action Platform is an international university-business alliance based at oneC1TY to advance scalable, sustainable solutions to meet the global challenges of a world of ten billion. Our focus is on solutions for abundant food, health, and prosperity. Food and agriculture link us to the natural world; nutritious food multiplies into health; and health multiplies into prosperity. Food, health, and prosperity, in short, link and create exponential effects. The importance of these three areas is validated by the Sustainable Development Goals just announced at the United Nations, which target food, health, and prosperity as the top three global priorities. Scalable, sustainable solutions in food, health, and prosperity are essential to meet the needs of the megacities and agricultural regions of the future. THOUGHT LEADERSHIP AND INVESTMENTS To advance solutions in these areas, Global Action Platform has created a collaborative platform to mobilize the world’s foremost experts and executive leaders; target impact investments in innovation and businesses; leverage
technology for collaboration and data analytics; and communicate findings globally. This activity is organized through the core programs of Global Action Platform—Convene, Challenge, Connect, and Communicate. CONVENE—annual Summits and forums to mobilize experts and executive leaders CHALLENGE—impact investment funds to create self-sustaining, transformative solutions for food, health, and economic issues CONNECT—smart technology collaboration groups and tools combined with data analytics COMMUNICATE—global communications through reports, broadcast, and social media URBAN AND RURAL LABORATORIES Global Action Platform uses the activities above to engage the world’s top experts and leaders and then applies these ideas in urban and rural “living laboratories.” Applying the best ideas in rural and urban models creates an ongoing feedback loop to advance real world solutions.
oneC1TY
CARAGA—THE PHILIPPINES
SUMMARY
oneC1TY is a global urban model being developed in Nashville, Tennessee by Cambridge Holdings as a living laboratory for nutrition, mindful healthy living, and shared value enterprise. Global Action Platform serves as the think tank and convener for the project. Located on a twenty-acre campus with a million square feet of office, residential, and retail space, oneC1TY is designed to be more than a mixed use urban development. oneC1TY is a community, a culture, defined by a set of values. The campus in Nashville serves as the prototype for a series of oneC1TY campuses to be developed in other cities around the world, and to serve as a model for how urban centers can accelerate and expand the spread of healthy diets and lifestyles and the growth of shared prosperity to accommodate the megacities of the future.
As the nonprofit founding partner of the Global Partnership for Sustainable Solutions, Global Action Platform is also engaged in creating a comprehensive social-economic-environmental development model for large-scale rural development in the Caraga region of the Philippines. Working directly with the Indigenous People’s Economic Union (IPEU), Global Action Platform and its partners are creating strategic action plans for the development of 1.2M acres of undeveloped land in the tropics. The area is expected to expand from its initial scale to some 5-10M acres, as work gets underway. The Caraga project offers the opportunity to create an approach to rural development at scale and in a way that can be replicated and used to advance the innovative food solutions to feed the world’s growing population.
Global Action Platform works to create a world of abundance for every person. We do this by engaging the world’s top experts and leaders in the ongoing events, investments, collaborations and communications of the Global Action Platform, while applying ideas from these activities into the design and development of rural and urban models, most notably at oneC1TY-Nashville and the Caraga, Philippines. ■
Food and agriculture link us to the natural world; nutritious food multiplies into health; and health multiplies into prosperity. Food, health, and prosperity, in short, link and create exponential effects. SEPTEMBER 2016
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SPONSORS THANK YOU! LEAD INSTITUTIONAL PARTNERS
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We thank our sponsors for their generous support of the Global Action Summit and the Global Action Platform:
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collaboration | innovation | technology | you
nashville
a Cambridge mindful living community
oneC1TY is a collection of diverse places designed as a catalyst for mindful, healthy living and a fully integrated extension of Nashville’s urban fabric.
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The WATERSHED Water quality gardens double as a series of outdoor rooms for great minds to steep and chance meetings to change our world.
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The LOOP The urban, modern lane brings together office + residential uses to create, collaborate and cohabitate.
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The YARD A community lawn and stage anchor this multipurpose gathering place surrounded by Nashville’s finest outdoor dinning experience.
oneC1TY captures advancements in the human experience that result from collaborations in healthcare, information technology, scientific research, entrepreneurship and a mindful development philosophy. These synergies are woven into the public spaces and the built environment that comprise oneC1TY.
GLOBAL THOUGHT driving innovation through collaboration
LOCAL IMPACT reflecting Nashville’s investments in health, culture and our unique urban fabric
PERSONAL HEALTH leveraging the opportunity to be students of mindful living and improve human performance
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COMMUNITY TABLE Anchored by healthy eating, local food is the main focus for this teaching and dinning experience. Nothing brings a community together like food (and music).
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C1TY AVENUE oneC1TY’s high touch pedestrian shopping experience brings together the best local + national retailers that embody our quest for a high quality of life.
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C1TY BLVD This lush boulevard is not only the collector for everyday traffic, but also the poster child for sustainable living.